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Individual

DR. PRASAD R. GUDAVALLI

Active
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Individual

DR. PRASAD R. GUDAVALLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
128146
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00366349
NY
01
0046803
GROUP HEALTH INC.
NY
01
069508709
OXFORD HEALTH PLAN
NY
01
069508793
UNITED HEALTHCARE
NY
01
07A361
BLUE CROSS & BLUE SHIELD
NY
01
0C0646
HEALTHNET
NY
01
1000016766
AFFINITY
NY
01
128146-A21
HEALTHFIRST
NY
01
4556190
CIGNA HEALTHCARE
NY
01
97367
AETNA US HEALTHCARE
NY
01
OXFORD
P393018
NY
Enumeration date
06/20/2005
Last updated
11/05/2012
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