Individual
DR. SHANTI PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 COLUMBIA PIKE, SUITE 131, ARLINGTON, VA 22204-4547
(703) 979-1777
(703) 979-8258
Mailing address
2001 COLUMBIA PIKE, SUITE 131, ARLINGTON, VA 22204-4547
(703) 979-1777
(703) 979-8258
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101227771
VA
207R00000X
Internal Medicine Physician
Primary
0101227771
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5860105
—
VA
Enumeration date
06/12/2006
Last updated
12/17/2012
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