Organization
PRASAD POLISETTY MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN SHERRILL (BILLING ADMIN)
(423) 646-1862
Entity
Organization
Contact information
Practice address
120 12TH ST, PRINCETON, WV 24740
(304) 487-8000
Mailing address
PO BOX 791825, BALTIMORE, MD 21279-1825
(248) 633-4262
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
283X00000X
Rehabilitation Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376711291
—
WV
Enumeration date
10/05/2022
Last updated
01/15/2026
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