Provider Demographics
NPI:1588659031
Name:SEKARAN, SOMASUNDRARAM K (MD)
Entity Type:Individual
Prefix:
First Name:SOMASUNDRARAM
Middle Name:K
Last Name:SEKARAN
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 1:117 S MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-6024
Mailing Address - Country:US
Mailing Address - Phone:724-283-1515
Mailing Address - Fax:724-283-1028
Practice Address - Street 1:117 S MCKEAN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-6024
Practice Address - Country:US
Practice Address - Phone:724-283-1515
Practice Address - Fax:724-283-1028
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031977L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B39420Medicare UPIN
143282Medicare ID - Type Unspecified