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Individual

SHASHI KUMAR PRABHAKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13700 ST FRANCIS BLVD, SUITE 600, MIDLOTHIAN, VA 23114-3222
(804) 794-6400
(804) 897-0910
Mailing address
13700 ST FRANCIS BLVD, SUITE 600, MIDLOTHIAN, VA 23114-3222
(804) 794-6400
(804) 897-0910

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101232902
VA
207RC0000X
Cardiovascular Disease Physician
Primary
0101232902
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C09462
GROUP PTAN
VA
Enumeration date
01/06/2006
Last updated
07/31/2012
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