Individual
PRABHAKAR PISIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
30143
IA
2084P0805X
Geriatric Psychiatry Physician
4301061688
MI
2084P0805X
Geriatric Psychiatry Physician
Primary
79002
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2115774
—
IA
01
—
79002
GA LICENSE
GA
Enumeration date
06/26/2005
Last updated
11/01/2023
Update your record
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