Individual
PONATHPUR K PRAHALAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 MULBERRY ST, SCRANTON, PA 18510-2369
(570) 346-7797
(570) 342-9802
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD026116E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050079858
RR MEDICARE
PA
05
—
0975904
—
PA
Enumeration date
11/08/2005
Last updated
08/19/2020
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