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NPI Code Detail

MEDICARE: DR. NISHA DEOL M.D.

MEDICARE: DR. NISHA DEOL 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
1208M00000XHospitalist PhysicianDR.0061781CO
2207R00000XInternal Medicine Physician35133173OH
3208M00000XHospitalist Physician35133173OH

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 : 1457735318
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NISHA DEOL M.D.
Provider Business Mailing Address
First Line : 1 PRESTIGE PL STE 550
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-6115
Country : US
Telephone Number : 937-558-0200
Fax Number : 937-558-0158
Provider Business Practice Location Address
First Line : 405 W GRAND AVE
Second Line :
City : DAYTON
State : OH
Zip : 45405-7538
Country : US
Telephone Number : 937-723-3276
Fax Number : 937-723-3277
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2015
Last Update Date : 03/19/2026

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Directions to “ DR. NISHA DEOL M.D.” Practice Location

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