Provider Demographics
NPI:1174501282
Name:SETHI, SHASHI KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SHASHI
Middle Name:KUMAR
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:719 GREEN VALLEY ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408
Mailing Address - Country:US
Mailing Address - Phone:336-230-1010
Mailing Address - Fax:336-230-1014
Practice Address - Street 1:719 GREEN VALLEY ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:336-230-1010
Practice Address - Fax:336-230-1014
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2007-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC30237207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
08-00383OtherUNITED HEALTH CARE
75235OtherBLUE CROSS
NC8975235Medicaid
75235OtherBLUE CROSS
NC8975235Medicaid