Prasad, Miramar S

Prasad, Miramar S is an individual health care provider with primary practice located at 5401 44Th Avenue Drive Suite 100, Moline IL 51265-6401. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Prasad, Miramar S can be contacted via phone (309) 779-5439.

Contact Information

Primary practice address
5401 44Th Avenue Drive Suite 100 Moline IL 51265-6401
Phone: (309) 779-5439
Fax: (309) 558-7026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036084335 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036084335 Illinois

Profile Details

NPI number 1235105826
LBN Legal business name Prasad, Miramar S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Jan 15th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235105826 NPPES
Iowa MEDICAID 2924712
Iowa MEDICAID 1235105826

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