Individual
DR. SUDHA R PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3836 PARK AVE, MEMPHIS, TN 38111-6633
(901) 324-3984
(901) 454-1655
Mailing address
PO BOX 17962, MEMPHIS, TN 38187-7962
(901) 324-3984
(901) 454-1655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12949
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25923
BLUE CROSS BLUE SHIELD
TN
05
—
3183447
—
TN
Enumeration date
11/27/2006
Last updated
03/22/2013
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