Individual
DR. PRAKASH VISWANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9855 HOSPITAL DR STE 102B, MAPLE GROVE, MN 55369-5021
(763) 581-5600
(763) 581-5601
Mailing address
9855 HOSPITAL DR STE 102B, MAPLE GROVE, MN 55369-5021
(763) 581-5600
(763) 581-5601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
250191
NY
207RG0100X
Gastroenterology Physician
250191
NY
207RG0100X
Gastroenterology Physician
62460
MN
207RG0100X
Gastroenterology Physician
Primary
MD23388
ME
Other
Enumeration date
09/04/2008
Last updated
07/21/2022
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