Individual
PRAKASH PANDALAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ROSE ST, 1ST FL, LEXINGTON, KY 40536
(859) 323-6542
(859) 323-2074
Mailing address
8008 WESTPARK DR, MC LEAN, VA 22102-3109
(240) 330-9506
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35085025
OH
2086X0206X
Surgical Oncology Physician
Primary
53095
KY
2086X0206X
Surgical Oncology Physician
TP594
KY
Other
Enumeration date
06/05/2007
Last updated
05/05/2021
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