Individual
MALAVIKA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
411 E CHESTNUT ST, LOUISVILLE, KY 40202-1713
(502) 588-4970
(502) 588-4970
Mailing address
PO BOX 776879, CHICAGO, IL 60677-0909
(502) 588-9490
(502) 588-7713
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
53101
KY
208000000X
Pediatrics Physician
TP642
KY
2080P0210X
Pediatric Nephrology Physician
Primary
53101
KY
390200000X
Student in an Organized Health Care Education/Training Program
183693
NC
Other
Enumeration date
06/22/2012
Last updated
09/03/2021
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