DR. PRASAD VENKATA DEVABHAKTUNI M.D. NPI 1417027103

NPI Information

NPI: 1417027103
Provider Name: DR. PRASAD VENKATA DEVABHAKTUNI, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

PECOS Registration: Yes

Address:
14 E GRAFTON RD
SUITE C
FAIRMONT, WV
ZIP 26554
Phone: (304) 363-7773
Get Directions

DR. Prasad Venkata Devabhaktuni, M.D. is a pulmonary disease internal medicine in Fairmont, WV. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Prasad Venkata Devabhaktuni, M.D. NPI is 1417027103. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14 E GRAFTON RD
SUITE C
FAIRMONT, WV
ZIP 26554-465
Phone: (304) 363-7773
Fax: (304) 363-7773

The NPI 1417027103 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 9/25/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0200X	Internal Medicine	Critical Care Medicine	15587	WEST VIRGINIA	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	15587	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MA9262431	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA	GRP MED PROVIDER NUMBER
2	D49448	MEDICARE UPIN	WEST VIRGINIA
3	DE0621492	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA	IND MED PROVIDER
4	0071632000	MEDICAID	WEST VIRGINIA
5	0009095000	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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