Provider Demographics
NPI:1972560894
Name:SETHI, PRAMODKUMAR PISHORILAL (MD)
Entity type:Individual
Prefix:DR
First Name:PRAMODKUMAR
Middle Name:PISHORILAL
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 29568
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27429-9568
Mailing Address - Country:US
Mailing Address - Phone:336-273-2511
Mailing Address - Fax:336-370-0287
Practice Address - Street 1:912 THIRD STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6967
Practice Address - Country:US
Practice Address - Phone:336-273-2511
Practice Address - Fax:336-370-0287
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2004-009692084N0400X, 2084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00015474OtherPALMETTO GBA RR MEDICARE
NCP00015474OtherPALMETTO GBA RR MEDICARE
NC2030455Medicare PIN