Provider Demographics
NPI:1518270552
Name:PRASAD, ASHOK JOSHWA (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:JOSHWA
Last Name:PRASAD
Suffix:
Gender:M
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:PO BOX 3339
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3339
Mailing Address - Country:US
Mailing Address - Phone:855-739-9953
Mailing Address - Fax:571-659-9445
Practice Address - Street 1:1300 HOSPITAL DR STE 302
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8451
Practice Address - Country:US
Practice Address - Phone:855-739-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248441207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06380OtherMEDICARE OF VA PTAN
DCG00773OtherMEDICARE DC PTAN