Basic Information
Provider Information
NPI: 1639458987
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SETHI
FirstName: POOJA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3601 4TH ST
Address2:  
City: LUBBOCK
State: TX
PostalCode: 794309410
CountryCode: US
TelephoneNumber: 3348743463
FaxNumber:  
Practice Location
Address1: 4371 NARROW LANE RD
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361162971
CountryCode: US
TelephoneNumber: 3348743463
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/04/2011
LastUpdateDate: 01/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XR7885TXY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
208M00000XR7885TXN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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