Devabhaktuni, Prasad Venkata
Devabhaktuni, Prasad Venkata is an sole proprietor health care provider with primary practice located at 14 E Grafton Rd Suite C, Fairmont WV 26554-4465. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Devabhaktuni, Prasad Venkata can be contacted via phone (304) 363-7773.Contact Information
Primary practice address
14 E Grafton Rd Suite C
Fairmont WV 26554-4465
Phone: (304) 363-7773
Fax: (304) 363-7773
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 15587 | West Virginia |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 15587 | West Virginia |
Profile Details
| NPI number | 1417027103 |
|---|---|
| LBN Legal business name | Devabhaktuni, Prasad Venkata |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2006 |
| Last updated | Sep 25th, 2012 - about 13 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 | 1417027103 | NPPES |
| West Virginia | MEDICAID | 0009095000 | |
| West Virginia | MEDICAID | 0071632000 |
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