Provider Demographics
NPI:1285856278
Name:BAIRSETTY, ADARSH (MD)
Entity Type:Individual
Prefix:
First Name:ADARSH
Middle Name:
Last Name:BAIRSETTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 SOUTHLAND DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-4080
Mailing Address - Country:US
Mailing Address - Phone:217-422-0311
Mailing Address - Fax:217-422-0416
Practice Address - Street 1:550 SOUTHLAND DR
Practice Address - Street 2:SUITE 1
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-4080
Practice Address - Country:US
Practice Address - Phone:217-422-0311
Practice Address - Fax:217-422-0416
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036122575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine