Provider Demographics
NPI:1417268244
Name:PRASIDTHRATHSINT, KUNATUM (MD)
Entity Type:Individual
Prefix:MS
First Name:KUNATUM
Middle Name:
Last Name:PRASIDTHRATHSINT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:SW 54 GH
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-7740
Mailing Address - Fax:319-356-4600
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:SW 54 GH
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-7740
Practice Address - Fax:319-356-4600
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD44219207R00000X
IAMD-44219207ZP0102X, 208M00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist