MEDICARE: VINAY PRASAD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0213X	Pediatric Pathology Physician	E-4800	AR
2	207ZP0213X	Pediatric Pathology Physician	55418	TN
3	207ZP0213X	Pediatric Pathology Physician	35.090576	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E4800	OTHER	AR	TRICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053411694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINAY PRASAD MD

Provider Business Mailing Address
First Line	:	VANDERBILT MEDICAL CTR
Second Line	:	C-3322 MEDICAL CTR N
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2561
Country	:	US
Telephone Number	:	615-322-3234
Fax Number	:	615-322-5551

Provider Business Practice Location Address
First Line	:	C-3322 MEDICAL CTR N
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2561
Country	:	US
Telephone Number	:	615-322-3234
Fax Number	:	615-322-5551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/11/2017

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Directions to “ VINAY PRASAD MD” Practice Location

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