Provider Demographics
NPI:1194752485
Name:SAVANA, PRASAD V (MD)
Entity type:Individual
Prefix:DR
First Name:PRASAD
Middle Name:V
Last Name:SAVANA
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 1:108 OLD SOLOMONS ISLAND RD STE U10
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3848
Mailing Address - Country:US
Mailing Address - Phone:410-573-0888
Mailing Address - Fax:410-949-2168
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD STE U10
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3848
Practice Address - Country:US
Practice Address - Phone:410-573-0888
Practice Address - Fax:410-949-2168
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223371-1207R00000X
MDD69482207R00000X
CO44857207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418314200Medicaid
287470OtherKAISER
95880801OtherBCBS MARYLAND
14572700OtherDEPT. OF LABOR
S3990058OtherBCBS DC
287470OtherKAISER
P00917255Medicare PIN
NYRA2415Medicare PIN
COC811199Medicare PIN
14572700OtherDEPT. OF LABOR
95880801OtherBCBS MARYLAND
MD418314200Medicaid
689L162621ZADNMedicare PIN