Individual
PRAKASH NALLANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8851 SOUTHPOINTE DR STE A1, INDIANAPOLIS, IN 46227-0805
(317) 497-4386
(317) 203-5213
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01087407A
IN
207R00000X
Internal Medicine Physician
66413
WI
207RR0500X
Rheumatology Physician
Primary
01087407A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100087869
—
WI
01
—
266180L32
MEDICARE PIN
—
05
—
300063672
—
IN
01
—
Q00399544
RAILROAD MEDICARE
IN
Enumeration date
03/22/2016
Last updated
11/07/2024
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