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NPI Code Detail

MEDICARE: SESHAGIRIRAO PEMMARAJU MD

MEDICARE: SESHAGIRIRAO PEMMARAJU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianR2634AR

General Provider Information

NPI Number : 1508853839
Entity Type Code : Individual
Provider Name (Legal Business Name) : SESHAGIRIRAO PEMMARAJU MD
Provider Business Mailing Address
First Line : 801 CENTRAL AVE STE 32
Second Line : PO BOX 846
City : HOT SPRINGS
State : AR
Zip : 71902
Country : US
Telephone Number : 501-624-4547
Fax Number : 501-624-5697
Provider Business Practice Location Address
First Line : 300 WERNER ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6406
Country : US
Telephone Number : 501-622-1048
Fax Number : 501-622-1847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 07/08/2007

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Directions to “ SESHAGIRIRAO PEMMARAJU MD” Practice Location

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