Individual
MRIDULA PRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9250 COLUMBIA AVE, SUITE C1, MUNSTER, IN 46321-3538
(219) 836-0039
(219) 836-0288
Mailing address
9250 COLUMBIA AVE, SUITE C1, MUNSTER, IN 46321-3538
(219) 836-0039
(219) 836-0288
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01032446
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100340470B
—
IN
Enumeration date
03/28/2006
Last updated
12/08/2011
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