Provider Demographics
NPI:1114988219
Name:VALLABH, SAGAR VIHARI (MD)
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:VIHARI
Last Name:VALLABH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 SHENANGO VALLEY FWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2536
Mailing Address - Country:US
Mailing Address - Phone:724-983-0223
Mailing Address - Fax:724-983-1317
Practice Address - Street 1:2501 SHENANGO VALLEY FWY
Practice Address - Street 2:SUITE 3
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2536
Practice Address - Country:US
Practice Address - Phone:724-983-0223
Practice Address - Fax:724-983-1317
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027260E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA33299OtherHEALTH AMERICA
OH0618620OtherOH MEDICAID
PA0008698210001Medicaid
PA2735756-001OtherCIGNA
PA100000297OtherRAILROAD MEDICARE
PA0004283298OtherAETNA
PA100118OtherHIGHMARK BC BS
OH000000114827OtherANTHEM
PA102940OtherUPMC
PA100118QJ4Medicare ID - Type Unspecified
PA0008698210001Medicaid