Individual
DR. PRASAD POLISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1735 W STATE OF FRANKLIN RD STE 5, JOHNSON CITY, TN 37604-6586
(423) 646-1862
Mailing address
PO BOX 791825, BALTIMORE, MD 21279-1825
(248) 633-4262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301090287
MI
Other
Enumeration date
02/13/2008
Last updated
01/15/2026
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