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General NPI Number Information
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NPI Number | 1760460349
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Entity Type | Individual
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Provider Name | DR. SUMAN PRASAD
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Gender | Female
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 1417 W PETTIGREW ST
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City | DURHAM
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State | NC
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Zip | 27705-4820
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Country | US
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Telephone | 919-286-7705
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Fax |
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Provider Business Mailing Address
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Address Line | 3521 FOREST OAKS DR
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City | CHAPEL HILL
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State | NC
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Zip | 27514-7417
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Country | US
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Telephone | 919-636-0461
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Fax | 919-428-2905
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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 | 200301403
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License Number State | NC
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