Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD60763207 | WA |
NPI | 1225263809 |
---|---|
Provider Name | Dr. Arun Raghav Mahankali Sridhar |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 22/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1225263809 | (05) | WA |
8968462 | MEDICARE PIN (01) | WA |