Provider Demographics
NPI:1174613863
Name:KOHLI, ASHA K (MD)
Entity type:Individual
Prefix:DR
First Name:ASHA
Middle Name:K
Last Name:KOHLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1475
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27533
Mailing Address - Country:US
Mailing Address - Phone:919-736-0203
Mailing Address - Fax:919-703-0488
Practice Address - Street 1:2300 US HWY 70 WEST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530
Practice Address - Country:US
Practice Address - Phone:919-736-0203
Practice Address - Fax:919-736-0488
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC265532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8950018Medicaid
NC2084P0800XMedicaid
204026Medicare ID - Type Unspecified