Individual
JAN PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3805 E BELL RD, SUITE 3100, PHOENIX, AZ 85032-2105
(602) 867-8644
(602) 795-5698
Mailing address
PO BOX 98819, LAS VEGAS, NV 89193-8819
(602) 867-8644
(602) 795-5698
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17912
AZ
207RI0011X
Interventional Cardiology Physician
17912
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279233
—
AZ
01
—
AZ0408430
BC/BS OF AZ
AZ
Enumeration date
12/16/2005
Last updated
04/12/2022
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