Provider Demographics
NPI:1508881483
Name:VISWANATHAN, PRABHA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRABHA
Middle Name:
Last Name:VISWANATHAN
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:SUITE 100 FLOOR 3.5 WEST WING
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-6151
Mailing Address - Fax:202-476-3850
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:SUITE 100 FLOOR 3.5 WEST WING
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-6151
Practice Address - Fax:202-476-3850
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD0388222080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases