MEDICARE: TAJ A RASHID MD INC

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
2	207R00000X	Internal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1508153289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAJ A RASHID MD INC

Provider Business Mailing Address
First Line	:	1500 YANKEE PARK PL
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-1878
Country	:	US
Telephone Number	:	937-436-1414
Fax Number	:	937-436-0805

Provider Business Practice Location Address
First Line	:	1500 YANKEE PARK PL
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-1878
Country	:	US
Telephone Number	:	937-436-1414
Fax Number	:	937-436-0805

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TAJ AHMAD RAHID
Credential	:	M.D.
Telephone Number	:	937-298-5536

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	01/09/2012

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