Prakash V Huded, MD
Individual provider Active NPI Gastroenterology Physician · Portland, CT
NPI 1760467237 · NPPES record last updated Jan 21, 2015
Key facts
- NPI
- 1760467237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 25374 (CT)
- Practice address
- 78 Marlborough St
Portland, CT 06480-4801 - Phone
- (860) 342-4800
- Fax
- (860) 342-3298
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 25374 | CT | Yes |
Addresses
Primary practice location
78 Marlborough St
Portland, CT 06480-4801
Mailing address
78 Marlborough St
Portland, CT 06480-4801
Phone (860) 342-4800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1253749 | Medicaid | CT |
Other providers in Portland, CT
- Donna S. Grisham
- Wendy Griswold
- Susan Mary Gubilee
- Linda Pantano Hassett
- Deborah B. Heilman
- Sumangala F Huded
- Kent Huynh
- J Crego LCSW LLC
- Jennifer Jamaitis
- JP Business LLC
All providers in Portland, CT · Gastroenterology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.