Individual
DR. BALA PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
PH USC PULMONARY, 300 PALMETTO HEALTH PARKWAY, COLUMBIA, SC 29212-1765
(803) 296-3273
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
260043-1
NY
207R00000X
Internal Medicine Physician
64322-20
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
260043-1
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
48315
KY
207RP1001X
Pulmonary Disease Physician
260043-1
NY
207RP1001X
Pulmonary Disease Physician
Primary
38574
SC
207RP1001X
Pulmonary Disease Physician
48315
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
385746
—
SC
Enumeration date
06/26/2007
Last updated
10/06/2020
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