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Individual

KARANVIR PRAKASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
325 CHARLES H DIMMOCK PKWY STE 100, COLONIAL HEIGHTS, VA 23834-2986
(804) 526-5888
(804) 526-5401
Mailing address
325 CHARLES H DIMMOCK PKWY, STE 100, COLONIAL HEIGHTS, VA 23834-2986
(804) 526-5888
(804) 526-5401

Taxonomy

Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
0101045456
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006402666
VA
01
200021403
RAILROAD MEDICARE
VA
Enumeration date
07/19/2005
Last updated
12/05/2017
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