Healthcare Provider Details

I. General information

NPI: 1154012458
Provider Name (Legal Business Name): DHIRAJ KRISHNA PEDDU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP STREET, 3RD FLOOR UPMC DIGESTIVE HEALTHCARE, UPMC PRESBYTERIAN
PITTSBURGH PA
15213
US

IV. Provider business mailing address

3600 FORBES AVENUE, FORBES TOWER, PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-8666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351050517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: