Provider Demographics
NPI:1477636660
Name:ASHOK PRASAD MD PC
Entity Type:Organization
Organization Name:ASHOK PRASAD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-449-1059
Mailing Address - Street 1:44000 W 12 MILE RD
Mailing Address - Street 2:STE 115
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2644
Mailing Address - Country:US
Mailing Address - Phone:248-449-1059
Mailing Address - Fax:
Practice Address - Street 1:44000 W 12 MILE RD
Practice Address - Street 2:STE 115
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2644
Practice Address - Country:US
Practice Address - Phone:248-449-1059
Practice Address - Fax:248-449-1092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1731402Medicaid
MIB46949Medicare UPIN
MI0P38860Medicare PIN
MI1731402Medicaid