Provider Demographics
NPI:1992734206
Name:SETHI, SURENDRA KUMAR (MD)
Entity type:Individual
Prefix:
First Name:SURENDRA
Middle Name:KUMAR
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5754
Mailing Address - Country:US
Mailing Address - Phone:724-282-1633
Mailing Address - Fax:724-282-3336
Practice Address - Street 1:230 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5754
Practice Address - Country:US
Practice Address - Phone:724-282-1633
Practice Address - Fax:724-282-3336
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033539L207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006763980001Medicaid
123231Medicare ID - Type Unspecified
PA0006763980001Medicaid