Individual
PRAVEEN SESHABHATTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 BLUEGRASS AVE, HIPS DEPT, LOUISVILLE, KY 40215-1161
(502) 367-3360
(502) 367-3365
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-3360
(502) 367-3365
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35087541
OH
207R00000X
Internal Medicine Physician
Primary
42999
KY
207RI0200X
Infectious Disease Physician
42999
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201062650
—
IN
05
—
7100154080
—
KY
05
—
PENDING
—
OH
Enumeration date
05/18/2006
Last updated
11/09/2023
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