Individual
SRIDHAR PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 JOHN DEERE ROAD, TRINITY 7TH STREET, MOLINE, IL 61265
(309) 779-5923
Mailing address
555 VALLEY VIEW DRIVE, MOLINE, IL 61265
(309) 743-7326
(309) 765-7999
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
28327
IA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3076513
—
IA
Enumeration date
12/04/2006
Last updated
07/08/2007
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