Provider Demographics
NPI:1245239391
Name:SIRSIKAR, SHRIRAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:SHRIRAM
Middle Name:P
Last Name:SIRSIKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1 TECH PARK DR
Practice Address - Street 2:SUITE 1150
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2515
Practice Address - Country:US
Practice Address - Phone:814-410-8300
Practice Address - Fax:814-410-8331
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD423546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009416780002Medicaid
PAIO4557Medicare UPIN
PA1009416780002Medicaid