Provider Demographics
NPI:1730267030
Name:KALAPALA, SESHAGIRI (MD)
Entity type:Individual
Prefix:
First Name:SESHAGIRI
Middle Name:
Last Name:KALAPALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KALAPALA
Other - Middle Name:SESHAGIRI
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1504 GRAND CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-1058
Mailing Address - Country:US
Mailing Address - Phone:304-485-7500
Mailing Address - Fax:304-485-6777
Practice Address - Street 1:805 FARSON ST STE 113
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1000
Practice Address - Country:US
Practice Address - Phone:740-401-1930
Practice Address - Fax:740-401-1937
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17059174400000X
OH35.066925208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0949102OtherOHIO MEDICADE
WV0078260000Medicaid
WVRAO0785422Medicare ID - Type Unspecified
OH0949102OtherOHIO MEDICADE