Provider Demographics
NPI:1407904808
Name:SETH, PRADIP (DPM)
Entity Type:Individual
Prefix:DR
First Name:PRADIP
Middle Name:
Last Name:SETH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 EAST KEMPER ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241
Mailing Address - Country:US
Mailing Address - Phone:513-489-5533
Mailing Address - Fax:513-489-5534
Practice Address - Street 1:6320 EAST KEMPER ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241
Practice Address - Country:US
Practice Address - Phone:513-489-5533
Practice Address - Fax:513-489-5534
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002264S213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2626313Medicaid
OH5591300001OtherDMERC P-TAN
OH5591300001OtherDMERC P-TAN
T80722Medicare UPIN