Individual
DR. DEVINA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13100 E 136TH ST, SUITE 3400, FISHERS, IN 46037-9417
(317) 678-3800
(317) 678-3830
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01075992A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100059030
MEDICAID GROUP
IN
05
—
201340520
—
IN
01
—
264430618
MEDICARE
IN
Enumeration date
11/04/2009
Last updated
02/16/2023
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