Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 46305 | AZ |
NPI | 1023229408 |
---|---|
Provider Name | Dr. Anil Bellur Seetharam |
First Address | Phoenix, AZ 85016-4418 |
Second Address | Scottsdale, AZ 85258-5086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 22/09/2020 |