Provider Demographics
NPI:1588806277
Name:PILLAI, PRASANTH (DO)
Entity Type:Individual
Prefix:DR
First Name:PRASANTH
Middle Name:
Last Name:PILLAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M-005
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-6350
Mailing Address - Fax:269-341-8580
Practice Address - Street 1:601 JOHN ST STE M-005
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5381
Practice Address - Country:US
Practice Address - Phone:269-341-6350
Practice Address - Fax:269-341-8580
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
MI51010201862080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program