Individual
MR. PRAKASH S BHOOPALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 404, MUNCIE, IN 47303
(765) 231-9494
(765) 587-4456
Mailing address
10520 ROXLEY BEND, CARMEL, IN 46032
(765) 729-5829
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01040631A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
01040631A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100362560
—
IN
Enumeration date
07/13/2005
Last updated
02/27/2025
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