Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01048844A | IN |
NPI | 1013974377 |
---|---|
Provider Name | Dr. Malathi Seshadri |
First Address | Michigan City, IN 46360-7310 |
Second Address | Michigan City, IN 46360-7310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 05/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000361726 | BCBS PIN NUMBER (01) | IN |
91115450 | BCBS IL PIN # (01) | IL |
C45674 | (02) | IN |