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General NPI Number Information
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NPI Number | 1255395182
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Entity Type | Individual
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Provider Name | PRAKASH N PANDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 1801 N SENATE BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1228
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Country | US
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Telephone | 317-962-0066
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44994
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City | INDIANAPOLIS
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State | IN
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Zip | 46244-0994
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01047953
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 01047953A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 01047953A
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License Number State | IN
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