1013183458 NPI number — ARTURO PRADA, M.D., P.C.

Table of content: (NPI 1013183458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013183458 NPI number — ARTURO PRADA, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARTURO PRADA, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013183458
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6700 N ROCHESTER RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
ROCHESTER HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48306-4362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-652-1202
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6700 N ROCHESTER RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
ROCHESTER HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48306-4362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-652-1202
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PRADA
Authorized Official First Name:
ARTURO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-652-1202

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  AP4301034898 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110636241 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110636274 . This is a "BLUE CROSS BLUE SHILED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110636274 . This is a "BLUE CAE NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110636271 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1427030147 . This is a "BLUE CROSS BLUE SHILED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110636241 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110636241 . This is a "BLUE CARE NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1427030147 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110636241 . This is a "COMMERCIAL INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1106362741 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1427030147 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".




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