Individual
PRAKASAM ANNAMALAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDN
Contact information
Practice address
10919 BENNETT DR, DAVIDSON, NC 28036-7657
(843) 452-0281
Mailing address
10919 BENNETT DR, DAVIDSON, NC 28036-7657
(843) 452-0281
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2389
SC
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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