Individual
PRAKASH MANIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 UNIVERSITY PKWY, SUITE 1500B, AIKEN, SC 29801-6810
(803) 643-7311
Mailing address
8400 RED BUG LAKE RD STE 1010, OVIEDO, FL 32765-6835
(407) 302-2620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27620
SC
208800000X
Urology Physician
Primary
ME134141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276203
—
SC
Enumeration date
12/16/2005
Last updated
01/04/2022
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