Healthcare Provider Details
I. General information
NPI: 1417940065
Provider Name (Legal Business Name): BRINDA K NAVALGUND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2005
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1275 S MAIN ST SUITE 103
GREENSBURG PA
15601-5385
US
IV. Provider business mailing address
120 VILLAGE DR
GREENSBURG PA
15601-3787
US
V. Phone/Fax
- Phone: 412-561-7246
- Fax: 412-235-4011
- Phone: 724-552-0585
- Fax: 412-235-4011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | MD420107 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: