Individual
DR. PRAKASH G ETTIGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6530 HULL STREET RD, RICHMOND, VA 23224
(804) 674-3425
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(305) 628-6117
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101028834
VA
Other
Enumeration date
08/06/2006
Last updated
10/30/2019
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