Individual
DR. PRASANTH NUTHAKKI
Active
Individual
DR. PRASANTH NUTHAKKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
01071908A
IN
208100000X
Physical Medicine & Rehabilitation Physician
01071908A
IN
208VP0014X
Interventional Pain Medicine Physician
Primary
01071908A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201134860
—
IN
Enumeration date
03/28/2007
Last updated
08/01/2021
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