Provider Demographics
NPI:1336428069
Name:SEELAM, SUSMITHA
Entity type:Individual
Prefix:
First Name:SUSMITHA
Middle Name:
Last Name:SEELAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 OAKVILLE DR
Mailing Address - Street 2:APT 2A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-4415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-2000
Practice Address - Fax:412-858-7628
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT200540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine