Individual
DR. PRASHANT KOLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Mailing address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-127849
IL
207R00000X
Internal Medicine Physician
1253054038
IL
207RN0300X
Nephrology Physician
2012003456
MO
207RN0300X
Nephrology Physician
Primary
50486
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023114
—
AZ
05
—
03612784901
—
IL
Enumeration date
09/03/2008
Last updated
09/02/2015
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