Prasad Shankariah MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301066496 Issued in MI

Legal business name

PRASAD SHANKARIAH MD PC

Practice address

1201 South Dr
Ste 131
Mt Pleasant, MI 48858-3256

Phone

(989) 779-5250

Fax

(989) 779-5251

NPI assigned

Aug 3, 2006

Last updated

Jun 25, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Florence E Kavanagh

Title

Supervisor

Phone

(989) 779-5250

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1548278997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "STE 131",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-779-5250",
            "fax_number": "989-779-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "STE 131",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-779-5250",
            "fax_number": "989-779-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASAD SHANKARIAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "KAVANAGH",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "989-779-5250"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301066496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4381630",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Erin Pope
• Timothy Bruce Popma
• Melissa Porter, M.S., C.A.D.C.
• Laura Potie, LCSW
• Practical Pediatrics
• Mary Jo Pray
• Precision Optical Services of Mt Pleasant LLC (Central Eye Wear)
• Prestige Centre
• Jocelyn Prewett
• Delana Lynn Price

• Internal Medicine Physician in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.