Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57-013833 | OH |
N | 111NI0900X | Internist | 57-013833 | OH |
N | 207W00000X | Ophthalmologist | 036128066 | IL |
Y | 207W00000X | Ophthalmologist | 46338 | AZ |
N | 207W00000X | Ophthalmologist | 52392 | WI |
NPI | 1013197375 |
---|---|
Provider Name | Dr. Shabari Sanat Seetharam |
First Address | Phoenix, AZ 85021-8860 |
Second Address | Phoenix, AZ 85021-8860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 11/01/2013 |