Healthcare Provider Details

I. General information

NPI: 1184622508
Provider Name (Legal Business Name): RAJKUMAR R SARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2005
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EASTERN AVE SUITE 100
PITTSBURGH PA
15215-3038
US

IV. Provider business mailing address

12 EASTERN AVE SUITE 100
PITTSBURGH PA
15215-3038
US

V. Phone/Fax

Practice location:
  • Phone: 412-782-1000
  • Fax: 412-782-4550
Mailing address:
  • Phone: 412-782-1000
  • Fax: 412-782-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD 070138L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD 070138L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: