Individual
JAYARAM D PRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2788 BAYARD ST, SUITE 201, EAST POINT, GA 30344-3441
(404) 768-3043
(404) 768-1781
Mailing address
2788 BAYARD ST, SUITE 201, EAST POINT, GA 30344-3441
(404) 768-3043
(404) 768-1781
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
035320
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00705592D
—
GA
Enumeration date
06/01/2006
Last updated
10/03/2011
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