Provider Demographics
NPI:1013183458
Name:ARTURO PRADA, M.D., P.C.
Entity Type:Organization
Organization Name:ARTURO PRADA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-652-1202
Mailing Address - Street 1:6700 N ROCHESTER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4362
Mailing Address - Country:US
Mailing Address - Phone:248-652-1202
Mailing Address - Fax:
Practice Address - Street 1:6700 N ROCHESTER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-4362
Practice Address - Country:US
Practice Address - Phone:248-652-1202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAP4301034898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
110636241OtherMEDICARE
110636274OtherBLUE CROSS BLUE SHILED
110636274OtherBLUE CAE NETWORK
110636271OtherMEDICARE
1427030147OtherBLUE CROSS BLUE SHILED
110636241OtherBLUE CROSS BLUE SHIELD
110636241OtherBLUE CARE NETWORK
MI1427030147Medicaid
110636241OtherCOMMERCIAL INSURANCE
1106362741OtherMEDICARE
1427030147OtherMEDICARE
1106362741OtherMEDICARE