Individual
PRANAV MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-6652
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-6652
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5281
MS
207RP1001X
Pulmonary Disease Physician
33229
MN
207RP1001X
Pulmonary Disease Physician
LT000913
PA
Other
Enumeration date
07/11/2022
Last updated
07/18/2024
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