Provider Demographics
NPI:1710073655
Name:PRASAD, KARIPINENI R (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIPINENI
Middle Name:R
Last Name:PRASAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3821 STARRS CENTRE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8003
Mailing Address - Country:US
Mailing Address - Phone:330-533-3102
Mailing Address - Fax:330-533-3123
Practice Address - Street 1:3821 STARRS CENTRE DR
Practice Address - Street 2:SUITE B
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8003
Practice Address - Country:US
Practice Address - Phone:330-533-3102
Practice Address - Fax:330-533-3123
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350410102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC31164Medicare UPIN
OH260012060OtherRAILROAD MEDICARE
OH000000126049OtherANTHEM BC & BS
OH202212Medicare ID - Type UnspecifiedPALMETTO GBA
OH63492000OtherMIS
OH47683OtherCIGNA BEHAVIORAL HEALTH