Individual
SOUMYA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21441
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR1746583
HIGHMARK BLUE S HIELD NUM
PA
Enumeration date
08/22/2005
Last updated
04/02/2020
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