MEDICARE: MRS. SUSHMA D NAGAR PA-C

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	363A00000X	Physician Assistant	50.002451	OH

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	:	1558560540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSHMA D NAGAR PA-C

Provider Business Mailing Address
First Line	:	4700 E GALBRAITH RD STE 300A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2754
Country	:	US
Telephone Number	:	513-347-9999
Fax Number	:	513-792-3239

Provider Business Practice Location Address
First Line	:	4700 E GALBRAITH RD STE 300A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2754
Country	:	US
Telephone Number	:	513-347-9999
Fax Number	:	513-792-3239

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	03/07/2022

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