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General NPI Number Information
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NPI Number | 1588732432
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Entity Type | Individual
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Provider Name | SHASHIDHAR R SHESHANI MBBS, MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 379 6TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-8820
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Country | US
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Telephone | 941-782-4100
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Fax | 941-782-4101
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Provider Business Mailing Address
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Address Line | PO BOX 9478
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City | BRADENTON
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State | FL
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Zip | 34206-9478
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Country | US
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Telephone | 941-782-4299
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Fax | 941-782-4301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | EC-06-1090
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 24529
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME121035
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License Number State | FL
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