Individual
PRASANNA PONUGOTI
Active
Individual
PRASANNA PONUGOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01076182A
IN
207R00000X
Internal Medicine Physician
2012020305
MO
207RG0100X
Gastroenterology Physician
Primary
01076182A
IN
208M00000X
Hospitalist Physician
01076182A
IN
208M00000X
Hospitalist Physician
2012020305
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790912830
—
MO
Enumeration date
06/16/2009
Last updated
07/07/2025
Update your record
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