Healthcare Provider Details

I. General information

NPI: 1083669634
Provider Name (Legal Business Name): RAGHAVAN MURUGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 06/15/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST FORBES STREET SUITE 9055
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

300 HALKET ST MAGEE WOMENS HOSPITAL
PITTSBURGH PA
15213-3108
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-4627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMD421971
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: