Individual
DR. PRAKASH BHUYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3900 WOODLAND AVE, UNIVERSITY AND WOODLAND AVENUES, PHILADELPHIA, PA 19104
(215) 823-5800
Mailing address
4131 JACKSON DR, LAFAYETTE HILL, PA 19444-1639
(215) 836-0520
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD418115
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD418115
LICENSE NUMBER
PA
Enumeration date
09/29/2006
Last updated
07/08/2007
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