Healthcare Provider Details

I. General information

NPI: 1447414438
Provider Name (Legal Business Name): PRASAD M NATARAJ MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 PLUMTREE ROAD B
BEL AIR MD
21015
US

IV. Provider business mailing address

208 PLUMTREE ROAD B
BEL-AIR MD
21015
US

V. Phone/Fax

Practice location:
  • Phone: 410-638-1999
  • Fax: 410-638-6355
Mailing address:
  • Phone: 410-638-1999
  • Fax: 410-638-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberD0046941
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0046941
License Number StateMD

VIII. Authorized Official

Name: DR. PRASAD M NATARAJ
Title or Position: MD
Credential: MDPC
Phone: 410-638-1999