Healthcare Provider Details

I. General information

NPI: 1871940726
Provider Name (Legal Business Name): ILAN KERMAN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 02/09/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY DRIVE C PITTSBURGH VA MEDICAL CENTER
PITTSBURGH PA
15240
US

IV. Provider business mailing address

UNIVERSITY DRIVE C
PITTSBURGH PA
15240
US

V. Phone/Fax

Practice location:
  • Phone: 866-482-7488
  • Fax:
Mailing address:
  • Phone: 412-822-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101267333
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: