Provider Information for 1205635125
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ASATO MAEHATA DMFT
Sex: Female
NPI: 1205635125
Last Updated: 2025-03-12
Certification Date: 2025-03-12
Certification Date: 2025-03-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205635125 | ||||||||
| Enumeration Date | 2025-03-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1632 VIRGINIA BEACH, VA 23451-9632 United States Phone: 757-425-6018 | Fax: | ||||||||
| Primary Practice Address | 1840 THOMAS LANE VIRGINIA BEACH, VA 23454 United States Phone: 757-425-6018 | Fax: | ||||||||
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