Provider Demographics
NPI:1548228299
Name:RASHKIN, MITCHELL CARL (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:CARL
Last Name:RASHKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-245-3104
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:200 EDEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220
Practice Address - Country:US
Practice Address - Phone:513-475-8523
Practice Address - Fax:513-475-7327
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-042583207R00000X, 207RP1001X
OH35042583207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200036290Medicaid
OH0479870Medicaid
KY64781800Medicaid
KY64781800Medicaid
OHH047240Medicare PIN
KY64781800Medicaid