Doctor Name: | DR. ABHILASH PERISETTI |
NPI Number: | 1396033650 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | RL11813 |
Business Practice Address: | 1111 Hayes Ave Sandusky, OH - 448703323 |
Business Phone Number: | 8183195817 |
Business Fax Number: | |
Mailing Address: | 26765 Carronade Dr, Apt 1204 PERRYSBURG |
State: | OH |
Postal Code: | 435516418 |
Phone Number: | 8183195817 |
Fax Number: | |
NPI Enumeration Date: | 07/20/2011 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | RL11813 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |