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General NPI Number Information
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NPI Number | 1619141017
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Entity Type | Individual
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Provider Name | RACHITA PRAKASH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 850 E HARVARD AVE STE 565
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City | DENVER
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State | CO
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Zip | 80210-5028
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Country | US
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Telephone | 303-777-3333
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Fax | 303-733-4441
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Provider Business Mailing Address
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Address Line | 306 N WILBUR AVE APT. NO. 2
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City | SAYRE
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State | PA
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Zip | 18840-1749
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Country | US
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Telephone | 650-776-2364
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT187630
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | DR.0058153
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License Number State | CO
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