Basic Information
Provider Information
NPI: 1003800020
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SESHUL
FirstName: MERRITT
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 304 10TH AVE NE
Address2:  
City: HICKORY
State: NC
PostalCode: 286013834
CountryCode: US
TelephoneNumber: 8283222183
FaxNumber: 8283282838
Practice Location
Address1: 304 10TH AVE NE
Address2:  
City: HICKORY
State: NC
PostalCode: 286013834
CountryCode: US
TelephoneNumber: 8283222183
FaxNumber: 8283282838
Other Information
ProviderEnumerationDate: 09/06/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000X NCY Allopathic & Osteopathic PhysiciansOtolaryngology 

ID Information
IDTypeStateIssuerDescription
89130KH05NC MEDICAID
130KH01 BCBSOTHER
835740000801 CIGNAOTHER


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