| Prafull Dave Md Pa | |
|
188 Thomas Johnson Dr Suite 200 Frederick MD 21702-4505 | |
| (301) 695-6556 | |
| (301) 695-5485 |
| Full Name | Prafull Dave Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 188 Thomas Johnson Dr, Frederick, Maryland |
| Authorized Official Name and Position | Prafull Dave (PRESIDENT) |
| Authorized Official Contact | 3016956556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prafull Dave Md Pa 188 Thomas Johnson Dr Suite 200 Frederick MD 21702-4505 Ph: (301) 695-6556 | Prafull Dave Md Pa 188 Thomas Johnson Dr Suite 200 Frederick MD 21702-4505 Ph: (301) 695-6556 |
| NPI Number | 1881715472 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 02/15/2013 |
| Medicare PECOS PAC ID | 5193777522 |
|---|---|
| Medicare Enrollment ID | O20130212000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881715472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | D20922 (Maryland) | Primary |
| Provider Name | Prafull K Dave |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326008582 PECOS PAC ID: 6002868437 Enrollment ID: I20110512000014 |
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