Individual
RAHUL PRATIVADI PRASANKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3460
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
253698
NY
207P00000X
Emergency Medicine Physician
Primary
MD.206167
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09823577
—
MS
05
—
2347543
—
LA
Enumeration date
06/25/2009
Last updated
05/21/2014
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