Individual
DR. PRAKASH NATHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9942
(877) 874-1008
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9942
(877) 874-1008
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
M1257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1736357-02
—
TX
Enumeration date
05/13/2006
Last updated
05/12/2011
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