Individual
DR. PRASAD B GUTTIKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4505 LOGAN WAY, HUBBARD, OH 44425-3311
(330) 259-3664
(330) 259-3665
Mailing address
4505 LOGAN WAY, HUBBARD, OH 44425-3311
(330) 259-3664
(330) 259-3665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-047510G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000252888
ANTHEM
—
05
—
0502638
—
OH
Enumeration date
07/12/2006
Last updated
07/09/2007
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