Healthcare Provider Details

I. General information

NPI: 1376470690
Provider Name (Legal Business Name): SHOBHIT KUMAR PRASAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYSTATE MEDICAL CENTER 759 CHESTNUT ST
SPRINGFIELD MA
01199
US

IV. Provider business mailing address

348 PARK STREET APT 226
WEST SPRINGFIELD MA
01089
US

V. Phone/Fax

Practice location:
  • Phone: 256-394-0495
  • Fax:
Mailing address:
  • Phone: 256-394-0495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: