Individual
PRAKASH S BEERAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SOUTH RAVENEL STREET, SUITE 160, FLORENCE, SC 29506-2610
(843) 662-1533
(843) 679-7273
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 662-1533
(843) 679-7273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30937
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005
BLUE CHOICE
SC
01
—
014
TRICARE
SC
01
—
18500
EVOLUTIONS
SC
01
—
20078271
SELECT HEALTH
SC
01
—
210717
MEDCOST
SC
01
—
2298624
CIGNA
SC
01
—
246983
UNISON
SC
05
—
309370
—
SC
05
—
5909956
—
NC
01
—
7135571
AETNA
SC
01
—
AA29248552
MEDICARE
SC
Enumeration date
01/25/2006
Last updated
02/01/2021
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