Provider Demographics
NPI:1609871045
Name:SESHACHARY, PARAVASTHU (MD)
Entity Type:Individual
Prefix:
First Name:PARAVASTHU
Middle Name:
Last Name:SESHACHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SESHA
Other - Middle Name:P
Other - Last Name:CHARY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:400 MATTHEW ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1644
Practice Address - Country:US
Practice Address - Phone:740-374-1525
Practice Address - Fax:740-374-5887
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045592207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0444148Medicaid
0488016Medicare ID - Type Unspecified
OH0444148Medicaid