Organization
DR SHRESTHA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIRANJAN SHRESTHA MD, FAAFP (PRESIDENT)
(567) 868-4507
Entity
Organization
Contact information
Practice address
1050 M L KING DR, SUITE 111, CENTRALIA, IL 62801-3060
(567) 868-4507
(877) 397-7287
Mailing address
605 SABLE DR, CENTRALIA, IL 62801-4472
(567) 868-4507
(877) 395-7287
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
IL
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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