Kandula, Prasad V

Kandula, Prasad V is an individual health care provider with primary practice located at 4600 Memorial Dr Ste W1 , Belleville IL 62226-5359. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Kandula, Prasad V can be contacted via phone (618) 233-3066.

Contact Information

Primary practice address
4600 Memorial Dr Ste W1 Belleville IL 62226-5359
Phone: (618) 233-3066
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036086651 Illinois
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X 036086651 Illinois
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 036086651 Illinois

Profile Details

NPI number 1164518460
LBN Legal business name Kandula, Prasad V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Aug 24th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164518460 NPPES
Illinois MEDICAID 036086651
Illinois MEDICAID 1164518460

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