Provider Demographics
NPI:1922012277
Name:KESHAVA, HESARAGHATTA BUDDAPPA (MD)
Entity Type:Individual
Prefix:DR
First Name:HESARAGHATTA
Middle Name:BUDDAPPA
Last Name:KESHAVA
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 1:1185 COUNTY HIGHWAY 122
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-6131
Mailing Address - Country:US
Mailing Address - Phone:518-752-5160
Mailing Address - Fax:
Practice Address - Street 1:1185 COUNTY HIGHWAY 122
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-6131
Practice Address - Country:US
Practice Address - Phone:518-752-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119483-1207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine