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General NPI Number Information
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NPI Number | 1568774800
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Entity Type | Individual
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Provider Name | RUSHYAL SHYAMRAJ M.D., MHSA
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Gender | Male
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 379 DIXMYTH AVE
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City | CINCINNATI
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State | OH
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Zip | 45220-2475
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Country | US
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Telephone | 513-246-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 4685 FOREST AVE
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City | CINCINNATI
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State | OH
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Zip | 45212-3397
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Country | US
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Telephone | 513-569-6111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4301097072
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.136718
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301097072
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License Number State | MI
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