Basic Information
| Provider Information | |||||||||
| NPI: | 1790866317 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRASAD | ||||||||
| FirstName: | YARLAGADDA | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 609 WEYBRIDGE DR | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483041083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483340685 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2550 S TELEGRAPH RD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483020950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483220001 | ||||||||
| FaxNumber: | 2483220004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 4301041868 | MI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.