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NPI Code Detail

MEDICARE: PRITHVIA RACHEL DEVADAS DO

MEDICARE: PRITHVIA RACHEL DEVADAS 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588308514
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRITHVIA RACHEL DEVADAS DO
Provider Business Mailing Address
First Line : 410 LARCH AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-3229
Country : US
Telephone Number : 715-207-8730
Fax Number :
Provider Business Practice Location Address
First Line : 401 N EWING ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-3371
Country : US
Telephone Number : 740-687-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2022
Last Update Date : 04/26/2022

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Directions to “ PRITHVIA RACHEL DEVADAS DO” Practice Location

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