Provider Demographics
NPI:1164479655
Name:GETTYSBURG LUNG CENTER, P.C.
Entity Type:Organization
Organization Name:GETTYSBURG LUNG CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRANKUMAR
Authorized Official - Middle Name:JAYRAM
Authorized Official - Last Name:VIRAMGAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-338-9797
Mailing Address - Street 1:124 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2121
Mailing Address - Country:US
Mailing Address - Phone:717-338-9797
Mailing Address - Fax:
Practice Address - Street 1:124 W HIGH ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2121
Practice Address - Country:US
Practice Address - Phone:717-338-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060678L207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02713500OtherBLUE CROSS GROUP
PA288651OtherMAMSI
MD617541-01OtherCAREFIRST RENDERING
MEKDJ7GEOtherCAREFIRST PROVIDER
PA01813301OtherBLUE CROSS PHYSICIAN
PA713031OtherHIGHMARK GROUP
PA431301OtherHIGHMARK PHYSICIAN
PA8338645-001OtherCIGNA
PA045386Medicare ID - Type Unspecified
PA713031OtherHIGHMARK GROUP