MEDICARE: OJASWA PRASAD DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	OT023822	PA

General Provider Information

NPI Number	:	1457943821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OJASWA PRASAD DO

Provider Business Mailing Address
First Line	:	505 BELLEMONT CT
Second Line	:
City	:	JOHNS CREEK
State	:	GA
Zip	:	30097-1967
Country	:	US
Telephone Number	:	678-910-2181
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 CITY AVE STE 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1627
Country	:	US
Telephone Number	:	215-871-6380
Fax Number	:

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

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	03/07/2026

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Directions to “ OJASWA PRASAD DO” Practice Location

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