Provider Demographics
NPI:1710306048
Name:PRASHANT, GIYARPURAM NADATHUR (MD)
Entity Type:Individual
Prefix:
First Name:GIYARPURAM
Middle Name:NADATHUR
Last Name:PRASHANT
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:MARSHALL MEDICAL OFFICES
Mailing Address - Street 2:905 MAPLE ST, THIRD FLOOR, DEPT. 370
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MARSHALL MEDICAL OFFICES
Practice Address - Street 2:905 MAPLE ST, THIRD FLOOR, DEPT. 370
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:90463
Practice Address - Country:US
Practice Address - Phone:650-299-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CAA142094207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program