Bontu, Prakash R
Bontu, Prakash R is an individual health care provider with primary practice located at 1236 E Rusholme St Suite 300, Davenport IA 52803-2473. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Bontu, Prakash R can be contacted via phone (563) 324-2992.Contact Information
Primary practice address
1236 E Rusholme St Suite 300
Davenport IA 52803-2473
Phone: (563) 324-2992
Fax: (563) 888-0499
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 24121 | Iowa |
Profile Details
| NPI number | 1912986837 |
|---|---|
| LBN Legal business name | Bontu, Prakash R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2006 |
| Last updated | Nov 21st, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912986837 | NPPES |
| Iowa | MEDICAID | 2218230 |
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