Provider Demographics
NPI:1447329891
Name:PRASAD, ANIL (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:PRASAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TYLER ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2951
Mailing Address - Country:US
Mailing Address - Phone:603-595-0063
Mailing Address - Fax:603-595-9419
Practice Address - Street 1:19 TYLER ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2951
Practice Address - Country:US
Practice Address - Phone:603-595-0063
Practice Address - Fax:603-595-9419
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH9195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007413Medicaid
NH30007413Medicaid