Provider Demographics
NPI:1174789416
Name:SEECHARAN, DAVE JASON (MD)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:JASON
Last Name:SEECHARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6600 SUGARLOAF PKWY STE 400-230
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4344
Mailing Address - Country:US
Mailing Address - Phone:678-250-0880
Mailing Address - Fax:
Practice Address - Street 1:454 SATELLITE BLVD NW STE 100
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7191
Practice Address - Country:US
Practice Address - Phone:678-250-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23117207T00000X
GA74992207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery