MEDICARE: DR. PRASHANT KUMAR NAGESHWAR M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	MD483588	PA
2	207RH0003X	Hematology & Oncology Physician	265150	MA
3	207RH0003X	Hematology & Oncology Physician	334207	LA
4	208M00000X	Hospitalist Physician	270985	NY

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

NPI Number	:	1760773428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRASHANT KUMAR NAGESHWAR M.D.

Provider Business Mailing Address
First Line	:	450 BROOKLINE AVE # 17
Second Line	:	DANA-FARBER CANCER INSTITUTE
City	:	BOSTON
State	:	MA
Zip	:	02215-5418
Country	:	US
Telephone Number	:	617-632-3382
Fax Number	:	617-582-9250

Provider Business Practice Location Address
First Line	:	75 FRANCIS ST
Second Line	:	BRIGHAM AND WOMEN'S HOSPITAL
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	617-632-3382
Fax Number	:

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

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	05/05/2026

75 FRANCIS STREET , BRIGHAM INTERNAL MEDICARE ASSOCIATES
BOSTON, MA
02115

Practice Phone: 617-732-6049
Practice Fax: 617-264-5202