MEDICARE: MR. PRAMODHYA CHIRASEVINUPRAPHAND MD

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	207R00000X	Internal Medicine Physician	041470	MA

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	:	1932197266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PRAMODHYA CHIRASEVINUPRAPHAND MD

Provider Business Mailing Address
First Line	:	259 MAIN ST
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-2115
Country	:	US
Telephone Number	:	508-881-4368
Fax Number	:	508-881-6300

Provider Business Practice Location Address
First Line	:	259 MAIN ST
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-2115
Country	:	US
Telephone Number	:	508-881-4368
Fax Number	:	508-881-6300

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	10/31/2011

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Directions to “ MR. PRAMODHYA CHIRASEVINUPRAPHAND MD” Practice Location

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