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NPI Code Detail

MEDICARE: SHAMSUDDIN C PRACHA MD

MEDICARE: SHAMSUDDIN C PRACHA MD
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
1208M00000XHospitalist Physician35.078920OH

Other Identifiers

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

General Provider Information

NPI Number : 1104872779
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMSUDDIN C PRACHA MD
Provider Business Mailing Address
First Line : PO BOX 634857
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-4857
Country : US
Telephone Number : 937-832-5292
Fax Number : 937-832-7505
Provider Business Practice Location Address
First Line : 8881 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45415-1333
Country : US
Telephone Number : 937-832-5292
Fax Number : 937-832-7505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 01/05/2021

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Directions to “ SHAMSUDDIN C PRACHA MD” Practice Location

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