Provider Demographics
NPI:1124027008
Name:GADE, PRASAD V (MD)
Entity Type:Individual
Prefix:DR
First Name:PRASAD
Middle Name:V
Last Name:GADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:520 MARY ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1682
Mailing Address - Country:US
Mailing Address - Phone:812-424-8231
Mailing Address - Fax:812-435-8794
Practice Address - Street 1:520 MARY ST STE 520
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1682
Practice Address - Country:US
Practice Address - Phone:812-424-8231
Practice Address - Fax:812-435-8794
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053157A208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64013089Medicaid
IN200303060Medicaid
CAA53043OtherCALIFORNIA LICENSE
IN01053157OtherINDIANA STATE LICENSE
IN000000174869OtherANTHEM BLUE CROSS/SHIELD
KY36733OtherKY LICENSE
G81310Medicare UPIN