Individual
ICHHA SETHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1640 E KEARNEY ST, SPRINGFIELD, MO 65803-4106
(417) 863-9190
(417) 863-9073
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2015021643
MO
207Q00000X
Family Medicine Physician
TEP NUMBER: 6811
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588911580
—
MO
Enumeration date
08/08/2012
Last updated
11/19/2015
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