Provider Demographics
NPI:1881678274
Name:PRASAD, ASHWINI (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHWINI
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 GOLDEN EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-6321
Mailing Address - Country:US
Mailing Address - Phone:262-402-7566
Mailing Address - Fax:
Practice Address - Street 1:2301 N LAKE DR,
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211
Practice Address - Country:US
Practice Address - Phone:414-585-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46553207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34593000Medicaid
WII23538Medicare UPIN
WI0025-65215Medicare ID - Type UnspecifiedPROVIDER NUMBER
WI0041-52590Medicare ID - Type UnspecifiedPROVIDER NUMBER