DR. HOSAMANE S PRABHAKARA MD

Allergy and Immunology

Fort Gordon, Georgia

Provider NPI: 1851364749

Provider Information:
DR. HOSAMANE S PRABHAKARA MD


Practice Location:
300 EAST HOSPITAL ROAD EISHENHOWER MEDICAL CTR FORT GORDON, GA 30905 US
Tel: 706-787-9123  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	208000000X	Physicians Pediatrics	GA	042394
N	207K00000X	Physicians Allergy & Immunology	GA	042394

Other Provider Identifiers:

Issuer	Number	State	Type
	00758458A	GA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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