Provider Demographics
NPI:1346320017
Name:PURIGHALLA, RAMAN (MD)
Entity Type:Individual
Prefix:
First Name:RAMAN
Middle Name:
Last Name:PURIGHALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 TECHNOLOGY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9531
Mailing Address - Country:US
Mailing Address - Phone:412-531-2902
Mailing Address - Fax:412-531-2948
Practice Address - Street 1:1050 BOWER HILL RD STE 202
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1867
Practice Address - Country:US
Practice Address - Phone:412-572-6122
Practice Address - Fax:412-561-0318
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-065003L174400000X
PAMD065003L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
110171496OtherRAILROAD MEDICARE PTAN
PA0017105650001Medicaid
PA020290JFZMedicare ID - Type Unspecified
PAG84442Medicare UPIN