Individual
PRASHANT KHETPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(602) 778-3600
Mailing address
PO BOX 708850, SANDY, UT 84070-8850
(866) 869-2395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
129407
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000544849
BCBS
OH
Enumeration date
07/11/2007
Last updated
02/04/2022
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