1730267030 NPI number — SESHAGIRI KALAPALA MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730267030 NPI number — SESHAGIRI KALAPALA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALAPALA
Provider First Name:
SESHAGIRI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAO
Provider Other First Name:
KALAPALA
Provider Other Middle Name:
SESHAGIRI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1730267030
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1504 GRAND CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26105-1058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-485-7500
Provider Business Mailing Address Fax Number:
304-485-6777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 FARSON ST STE 113
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELPRE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45714-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-401-1930
Provider Business Practice Location Address Fax Number:
740-401-1937
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  17059 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: 35.066925 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0949102 . This is a "OHIO MEDICADE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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