Individual
DR. SHASHI NMI PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
(320) 255-6378
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
(320) 255-6378
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
26578
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26578
MEDICAL LICENSE NO.
IA
Enumeration date
08/28/2006
Last updated
07/08/2007
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