Individual
BALAKRISHNA R PRABHAKAR
Active
Individual
BALAKRISHNA R PRABHAKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19872
WV
207R00000X
Internal Medicine Physician
Primary
N 1075
TX
208000000X
Pediatrics Physician
19872
WV
208000000X
Pediatrics Physician
N 1075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720356
MS BCBS
WV
05
—
6000462000
—
WV
01
—
N1075
MEDICAL LICENSE
TX
Enumeration date
03/14/2006
Last updated
05/01/2024
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