Individual
DR. GARY C. PRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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