Healthcare Provider Details

I. General information

NPI: 1194377069
Provider Name (Legal Business Name): VARUN KOMMALAPATI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 WASHINGTON AVE STE 205
BRIDGEVILLE PA
15017-2072
US

IV. Provider business mailing address

533 WASHINGTON AVE STE 205
BRIDGEVILLE PA
15017-2072
US

V. Phone/Fax

Practice location:
  • Phone: 412-475-9889
  • Fax:
Mailing address:
  • Phone: 412-475-9889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number280501
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD486161
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD486161
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number292818
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: