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General NPI Number Information
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NPI Number | 1629395686
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Entity Type | Individual
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Provider Name | PIA PRAKASH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 7120 MINSTREL WAY STE 100
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City | COLUMBIA
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State | MD
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Zip | 21045-5274
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Country | US
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Telephone | 410-290-6677
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Fax | 410-290-6676
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Provider Business Mailing Address
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Address Line | 7120 MINSTREL WAY STE 100
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City | COLUMBIA
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State | MD
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Zip | 21045-5274
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Country | US
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Telephone | 410-290-6677
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Fax | 410-290-6676
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0081625
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License Number State | MD
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