Provider Demographics
NPI:1053622126
Name:BIDE, PRALHAD SHANKAR (MD)
Entity type:Individual
Prefix:
First Name:PRALHAD
Middle Name:SHANKAR
Last Name:BIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:CHFHC, YEAPLE
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:CHFHC, YEAPLE
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NHRT 2044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine