Healthcare Provider Details

I. General information

NPI: 1417902503
Provider Name (Legal Business Name): SUBRAMANIA KRISHNASWAMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LOCUST ST SUITE 100
PITTSBURGH PA
15219-4738
US

IV. Provider business mailing address

1350 LOCUST ST SUITE 100
PITTSBURGH PA
15219-4738
US

V. Phone/Fax

Practice location:
  • Phone: 412-562-3292
  • Fax: 412-281-2610
Mailing address:
  • Phone: 724-929-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD028136E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: