MEDICARE: DR. KALPANA RAO PRAKASA 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
1	207R00000X	Internal Medicine Physician	D0059554	MD
2	208M00000X	Hospitalist Physician	D0059554	MD

General Provider Information

NPI Number	:	1740259134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KALPANA RAO PRAKASA M.D

Provider Business Mailing Address
First Line	:	7601 OSLER DRIVE
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204
Country	:	US
Telephone Number	:	410-427-2574
Fax Number	:	410-427-2054

Provider Business Practice Location Address
First Line	:	7601 OSLER DR
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7700
Country	:	US
Telephone Number	:	410-427-2574
Fax Number	:

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	06/10/2021

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