Healthcare Provider Details
I. General information
NPI: 1558354738
Provider Name (Legal Business Name): YESHVANT A NAVALGUND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2005
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 VILLAGE DR
GREENSBURG PA
15601-3707
US
IV. Provider business mailing address
120 VILLAGE DR
GREENSBURG PA
15601-3707
US
V. Phone/Fax
- Phone: 412-561-7246
- Fax: 866-580-7246
- Phone: 412-337-4476
- Fax: 412-235-4011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | 21330 |
| License Number State | WV |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | MD418539 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | ME149170 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: