Prasad Polisetty Md Pllc | |
120 12th St Princeton WV 24740 | |
(304) 487-8000 | |
Not Available |
Full Name | Prasad Polisetty Md Pllc |
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Speciality | Internal Medicine |
Location | 120 12th St, Princeton, West Virginia |
Authorized Official Name and Position | Sean Sherrill (BILLING ADMIN) |
Authorized Official Contact | 4236461862 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prasad Polisetty Md Pllc 204 Timber Ridge Dr Beckley WV 25801-3655 Ph: (248) 633-4262 | Prasad Polisetty Md Pllc 120 12th St Princeton WV 24740 Ph: (304) 487-8000 |
NPI Number | 1649995382 |
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Provider Enumeration Date | 10/05/2022 |
Last Update Date | 01/25/2023 |
Medicare PECOS PAC ID | 9335517663 |
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Medicare Enrollment ID | O20221117002494 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649995382 | NPI | - | NPPES |
1376711291 | Medicaid | WV |
Provider Name | Prasad Polisetty |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1376711291 PECOS PAC ID: 5799970398 Enrollment ID: I20101109000688 |
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