MEDICARE: DR. VIKRAM PRASAD 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	207RI0011X	Interventional Cardiology Physician	66188	AZ
2	207RC0000X	Cardiovascular Disease Physician	66188	AZ
3	207R00000X	Internal Medicine Physician	66188	AZ
4	207R00000X	Internal Medicine Physician	MT206375	PA
5	207R00000X	Internal Medicine Physician	MD460174	PA

General Provider Information

NPI Number	:	1740693548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIKRAM PRASAD M.D.

Provider Business Mailing Address
First Line	:	5301 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2805
Country	:	US
Telephone Number	:	520-327-5461
Fax Number	:	520-324-2051

Provider Business Practice Location Address
First Line	:	5301 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2805
Country	:	US
Telephone Number	:	520-327-5461
Fax Number	:

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

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	01/20/2026

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