Provider Demographics
NPI:1013974377
Name:SESHADRI, MALATHI (MD)
Entity Type:Individual
Prefix:DR
First Name:MALATHI
Middle Name:
Last Name:SESHADRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7310
Mailing Address - Country:US
Mailing Address - Phone:219-874-3313
Mailing Address - Fax:219-872-2425
Practice Address - Street 1:3723 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7310
Practice Address - Country:US
Practice Address - Phone:219-874-3313
Practice Address - Fax:219-872-2425
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048844A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000361726OtherBCBS PIN NUMBER
IL91115450OtherBCBS IL PIN #
IN000000361726OtherBCBS PIN NUMBER
IN487160MMedicare PIN
IN224440Medicare PIN