Provider Demographics
NPI:1053411694
Name:PRASAD, VINAY (MD)
Entity type:Individual
Prefix:
First Name:VINAY
Middle Name:
Last Name:PRASAD
Suffix:
Gender:M
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:VANDERBILT MEDICAL CTR
Mailing Address - Street 2:C-3322 MEDICAL CTR N
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2561
Mailing Address - Country:US
Mailing Address - Phone:615-322-3234
Mailing Address - Fax:615-322-5551
Practice Address - Street 1:C-3322 MEDICAL CTR N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2561
Practice Address - Country:US
Practice Address - Phone:615-322-3234
Practice Address - Fax:615-322-5551
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4800207ZP0213X
TN55418207ZP0213X
OH35.090576207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE4800OtherTRICARE
AR162844001Medicaid
ARE4800OtherTRICARE
ARH85777Medicare UPIN