MEDICARE: DR. ANITA MALASANI PRASAD OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618003594	VA

General Provider Information

NPI Number	:	1356206452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITA MALASANI PRASAD OD

Provider Business Mailing Address
First Line	:	387 BAKERS FERRY TRL
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-4902
Country	:	US
Telephone Number	:	706-231-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	9335 CHAMBERLAYNE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2805
Country	:	US
Telephone Number	:	804-264-2956
Fax Number	:	804-264-0447

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2025
Last Update Date	:	12/20/2025

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