MEDICARE: DR. HARISHCHANDRA RATHOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301085833	MI
2	207Q00000X	Family Medicine Physician	01064877A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487680005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARISHCHANDRA RATHOD M.D.

Provider Business Mailing Address
First Line	:	10000 STIRLING RD STE 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8067
Country	:	US
Telephone Number	:	954-589-5169
Fax Number	:	954-589-5169

Provider Business Practice Location Address
First Line	:	10000 STIRLING RD STE 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8067
Country	:	US
Telephone Number	:	954-589-5169
Fax Number	:	954-589-5169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	10/02/2023

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