Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 2021021858 | MO |
N | 207L00000X | Anesthesiologist | 6465420 | WI |
NPI | 1003233123 |
---|---|
Provider Name | Dr. Pawan S Sethi |
First Address | Saint Louis, MO 63128-3201 |
Second Address | Saint Louis, MO 63128-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 16/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300026326 | (05) | IN |