MEDICARE: PRASHANTH REDDY MOPALA 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	207RI0011X	Interventional Cardiology Physician	0101272158	VA
2	207RC0000X	Cardiovascular Disease Physician	0101272158	VA
3	207R00000X	Internal Medicine Physician	17520	NH
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1770514119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRASHANTH REDDY MOPALA MD

Provider Business Mailing Address
First Line	:	525 E MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44304-1619
Country	:	US
Telephone Number	:	330-375-3009
Fax Number	:	330-375-3804

Provider Business Practice Location Address
First Line	:	2075 GLENN MITCHELL DR STE 400
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-0179
Country	:	US
Telephone Number	:	757-252-9365
Fax Number	:	757-962-7217

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/20/2026

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