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NPI Code Detail

MEDICARE: PRUTHA ROHIT PATHAK MBBS, MPH

MEDICARE: PRUTHA ROHIT PATHAK MBBS, MPH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518654946
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRUTHA ROHIT PATHAK MBBS, MPH
Provider Business Mailing Address
First Line : 1701 VETERANS DR
Second Line :
City : FLORENCE
State : AL
Zip : 35630-4928
Country : US
Telephone Number : 256-629-1950
Fax Number :
Provider Business Practice Location Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2745
Country : US
Telephone Number : 719-595-7581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2023
Last Update Date : 06/04/2026

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