Individual
DR. GARY C. PRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11055 LITTLE PATUXENT PKWY, SUITE 104, COLUMBIA, MD 21044-2896
(410) 740-2900
(410) 740-2955
Mailing address
1111 BENFIELD BLVD, SUITE 200, MILLERSVILLE, MD 21108-3002
(410) 729-5100
(410) 729-5156
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0022587
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024210
JHHC PROVIDER NUMBER
MD
01
—
0477640
AETNA CAPITATED
MD
01
—
110140826
RR MEDICARE
MD
01
—
1342957
CIGNA PIN
MD
01
—
243371
MAMSI SPECIALIST
MD
01
—
3509-0005
CAREFIRST BLUECHOICE
MD
01
—
4238655
AETNA FEE FOR SERVICE
MD
05
—
443211800
—
MD
01
—
524039-01
CAREFIRST MD RENDERING
MD
01
—
843371
MAMSI PRIMARY CARE
MD
01
—
P12723
CAREFIRST MPOS
MD
Enumeration date
08/17/2005
Last updated
01/24/2011
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