Provider Demographics
NPI:1508153289
Name:TAJ A RASHID MD INC
Entity Type:Organization
Organization Name:TAJ A RASHID MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAJ
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:RAHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-298-5536
Mailing Address - Street 1:1500 YANKEE PARK PL
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1878
Mailing Address - Country:US
Mailing Address - Phone:937-436-1414
Mailing Address - Fax:937-436-0805
Practice Address - Street 1:1500 YANKEE PARK PL
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1878
Practice Address - Country:US
Practice Address - Phone:937-436-1414
Practice Address - Fax:937-436-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054896Medicaid
OH0054896Medicaid