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General NPI Number Information
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NPI Number | 1164884813
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Entity Type | Individual
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Provider Name | PRAKASH NALLANI
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Gender | Male
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 8851 SOUTHPOINTE DR STE A1
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-0805
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Country | US
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Telephone | 317-497-4386
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Fax | 317-203-5213
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01087407A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 66413
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 01087407A
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License Number State | IN
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