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NPI Code Detail

MEDICARE: DR. PRASAD G SRIPADA M.D.

MEDICARE: DR. PRASAD G SRIPADA M.D.
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
12084P0800XPsychiatry PhysicianG2487TX
22084P0800XPsychiatry Physician4301097755MI

General Provider Information

NPI Number : 1740216134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRASAD G SRIPADA M.D.
Provider Business Mailing Address
First Line : 9315 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-1260
Country : US
Telephone Number : 313-450-4500
Fax Number : 313-450-4512
Provider Business Practice Location Address
First Line : 9315 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-1260
Country : US
Telephone Number : 313-450-4500
Fax Number : 313-450-4512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 02/06/2014

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