Individual
RAMYA PRABHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6106
(617) 732-8613
Mailing address
3503 12TH STREET CT, MOLINE, IL 61265-7158
(309) 736-6292
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
036.180028
IL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/22/2021
Last updated
05/20/2026
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