Provider Demographics
NPI:1558530261
Name:PRABHAKARAN, RADHAI (MD,)
Entity Type:Individual
Prefix:DR
First Name:RADHAI
Middle Name:
Last Name:PRABHAKARAN
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:DR
Other - First Name:RADHAI
Other - Middle Name:
Other - Last Name:VARADAPPAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,
Mailing Address - Street 1:2568 SETON DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4937
Mailing Address - Country:US
Mailing Address - Phone:440-385-6691
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35094948208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics