1558354738 NPI number — DR. YESHVANT A NAVALGUND MD

Table of content: DR. YESHVANT A NAVALGUND MD (NPI 1558354738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558354738 NPI number — DR. YESHVANT A NAVALGUND MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAVALGUND
Provider First Name:
YESHVANT
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558354738
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 VILLAGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-3707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-337-4476
Provider Business Mailing Address Fax Number:
412-235-4011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 VILLAGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-3707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-561-7246
Provider Business Practice Location Address Fax Number:
866-580-7246
Provider Enumeration Date:
08/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X , with the licence number:  21330 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0000X , with the licence number: MD418539 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0000X , with the licence number: ME149170 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002822300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3000107000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011462270001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2545964 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011462270002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1634794 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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