Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | D39600 | MD |
NPI | 1265486252 |
---|---|
Provider Name | Sashidhar Seshukumar Movva |
First Address | Greenbelt, MD 20770-3602 |
Second Address | Greenbelt, MD 20770-3602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 02/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
082591300 | (05) | MD |
E84774 | (02) |