Provider Demographics
NPI:1366680829
Name:PRASAI, DIRGHA
Entity Type:Individual
Prefix:
First Name:DIRGHA
Middle Name:
Last Name:PRASAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 2ND ST NW
Mailing Address - Street 2:BOX 266
Mailing Address - City:TWIN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56584
Mailing Address - Country:US
Mailing Address - Phone:218-584-5142
Mailing Address - Fax:
Practice Address - Street 1:501 2ND ST NW
Practice Address - Street 2:BOX 266
Practice Address - City:TWIN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:56584
Practice Address - Country:US
Practice Address - Phone:218-584-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110013578Medicare PIN
MN110013580Medicare PIN
MN110013579Medicare PIN