Healthcare Provider Details

I. General information

NPI: 1093780082
Provider Name (Legal Business Name): MOHAN RAMKUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY DRIVE C ROOM 7E118 VA PITTSBURGH HEALTHCARE SYSTEM
PITTSBURGH PA
15240
US

IV. Provider business mailing address

UNIVERSITY DRIVE C ROOM 7E118 VA PITTSBURGH HEALTHCARE SYSTEM
PITTSBURGH PA
15240
US

V. Phone/Fax

Practice location:
  • Phone: 412-688-6000
  • Fax:
Mailing address:
  • Phone: 412-688-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD070676L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD070676L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: