MEDICARE: DR. PRAKASH RUFUS GANESH M.D.

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
1	207Q00000X	Family Medicine Physician	35.127085	OH
2	2083P0901X	Public Health & General Preventive Medicine Physician	35127085	OH

General Provider Information

NPI Number	:	1154680924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRAKASH RUFUS GANESH M.D.

Provider Business Mailing Address
First Line	:	3569 RIDGE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-5443
Country	:	US
Telephone Number	:	216-281-0872
Fax Number	:	216-961-5429

Provider Business Practice Location Address
First Line	:	NEIGHBORHOOD FAMILY PRACTICE
Second Line	:	3569 RIDGE ROAD
City	:	CLEVELAND
State	:	OH
Zip	:	44102
Country	:	US
Telephone Number	:	216-281-0872
Fax Number	:

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

Provider Enumeration Date	:	05/14/2012
Last Update Date	:	05/06/2026

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