Healthcare Provider Details

I. General information

NPI: 1346985058
Provider Name (Legal Business Name): YADESH MARAJ PRASHAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date: 02/09/2023
Reactivation Date: 02/23/2023

III. Provider practice location address

8901 CLEMENT AVE
PARKVILLE MD
21234-2603
US

IV. Provider business mailing address

951 FELL ST APT 319
BALTIMORE MD
21231-3589
US

V. Phone/Fax

Practice location:
  • Phone: 410-661-4670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0104089
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: