Provider Demographics
NPI:1528091758
Name:MOLAI, ASHTON VISHNU (DO)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:VISHNU
Last Name:MOLAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:200 W PARK CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3582
Mailing Address - Country:US
Mailing Address - Phone:336-716-2011
Mailing Address - Fax:
Practice Address - Street 1:200 W PARK CIR
Practice Address - Street 2:SUITE B
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3582
Practice Address - Country:US
Practice Address - Phone:336-838-4181
Practice Address - Fax:336-838-4185
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200000552207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCD557AMedicare PIN