Prabhu, Manjeshwar B.
Prabhu, Manjeshwar B. is an individual health care provider with primary practice located at 1730 E Lake Shore Dr Ste 301 , Decatur IL 62521-3809. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Prabhu, Manjeshwar B. can be contacted via phone (217) 329-1000.Contact Information
Primary practice address
1730 E Lake Shore Dr Ste 301
Decatur IL 62521-3809
Phone: (217) 329-1000
Fax: (217) 329-1055
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036083999 | Illinois |
Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 036083999 | Illinois |
Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 036-083999 | Illinois |
Profile Details
NPI number | 1770683450 |
---|---|
LBN Legal business name | Prabhu, Manjeshwar B. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 23rd, 2006 |
Last updated | Jan 3rd, 2022 - about 2 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 | 1770683450 | NPPES |
Illinois | MEDICAID | 036083999 |
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