Provider Demographics
NPI:1962457143
Name:SETHI, PRADEEP K (MD)
Entity Type:Individual
Prefix:
First Name:PRADEEP
Middle Name:K
Last Name:SETHI
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 1:108 SHADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2124
Mailing Address - Country:US
Mailing Address - Phone:412-877-2578
Mailing Address - Fax:
Practice Address - Street 1:108 SHADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2124
Practice Address - Country:US
Practice Address - Phone:412-877-2578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055298L207ZP0102X
FLME70627207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009872000001Medicaid
WV3810006827Medicaid
OH2655523Medicaid
PA1009872000001Medicaid
PA034857Medicare ID - Type Unspecified
PA220029521Medicare PIN
PA034857GXGMedicare PIN