MEDICARE: SANKETH PRODDUTUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD461835	PA

General Provider Information

NPI Number	:	1184037822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANKETH PRODDUTUR

Provider Business Mailing Address
First Line	:	2 EASTGATE AVE STE 101
Second Line	:	UPMC ST MARGARET HOSPITAL
City	:	MONESSEN
State	:	PA
Zip	:	15062-1392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 EASTGATE AVE STE 101
Second Line	:	UPMC ST MARGARET HOSPITAL
City	:	MONESSEN
State	:	PA
Zip	:	15062-1392
Country	:	US
Telephone Number	:	724-684-8999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2014
Last Update Date	:	05/24/2021

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Directions to “ SANKETH PRODDUTUR ” Practice Location

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