Provider Demographics
NPI:1215190418
Name:MUTHAVARAPU, SEETHA RAMA RAO (MD)
Entity Type:Individual
Prefix:
First Name:SEETHA
Middle Name:RAMA RAO
Last Name:MUTHAVARAPU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:180 W. ESPLANADE AVENUE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2467
Practice Address - Country:US
Practice Address - Phone:504-464-8588
Practice Address - Fax:504-412-1702
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202244207RG0300X
LAMD.202244208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1147575Medicaid
MS02224040Medicaid
LA4N199Medicare PIN
LA1147575Medicaid
LA4N1997061Medicare PIN