Provider Demographics
NPI:1619931276
Name:PRASAD, ARAKERE BANDIGOWDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARAKERE
Middle Name:BANDIGOWDA
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 1:4040 EST LA GRANDE PRINCESS
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-5165
Mailing Address - Country:US
Mailing Address - Phone:340-718-7788
Mailing Address - Fax:
Practice Address - Street 1:4040 EST LA GRANDE PRINCESS
Practice Address - Street 2:SUITE 1
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-5165
Practice Address - Country:US
Practice Address - Phone:340-718-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI621207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0080222Medicare PIN
VIG42938Medicare UPIN