Organization
MRIDULA PRASAD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRIDULA PRASAD M.D. (OWNER)
(219) 836-0039
Entity
Organization
Contact information
Practice address
9250 COLUMBIA AVE STE 1C, MUNSTER, IN 46321-3530
(219) 836-0039
(219) 836-0288
Mailing address
9250 COLUMBIA AVE STE 1C, MUNSTER, IN 46321-3530
(219) 836-0039
(219) 836-0288
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
IN
2084P0800X
Psychiatry Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000103391
BCBS IN
IN
01
—
91108099
BCBS IL
—
Enumeration date
02/27/2007
Last updated
09/11/2025
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