Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 155056 | MA |
N | 208600000X | Surgeon | 155056 | MA |
Y | 2086X0206X | Surgical Oncologist | 155056 | MA |
NPI | 1144204462 |
---|---|
Provider Name | Dr. Madhu Prasad |
First Address | Chicago, IL 60690-6310 |
Second Address | Anchorage, AK 99508-2959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 13/05/2021 |