Individual
PRABHUDEV PRASAD A PURUDAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
150 S HUNTINGTON AVE # 6C, BOSTON, MA 02130-4817
(857) 364-4720
Mailing address
150 S HUNTINGTON AVE # 6C, BOSTON, MA 02130-4817
(515) 574-6890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1016126
MA
207X00000X
Orthopaedic Surgery Physician
L-240117
MA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
MD40483
IA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
105713
MN
Other
Enumeration date
09/11/2009
Last updated
11/19/2024
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