Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 35.123424 | OH |
N | 207U00000X | Nuclear Medicine Specialist | 4301096774 | MI |
N | 207U00000X | Nuclear Medicine Specialist | 56922 | AZ |
NPI | 1174835003 |
---|---|
Provider Name | Dr. Prashant Jolepalem |
First Address | Gilbert, AZ 85297-8198 |
Second Address | Beachwood, OH 44122-7304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 02/10/2020 |