Provider Demographics
NPI:1417902503
Name:KRISHNASWAMI, SUBRAMANIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBRAMANIA
Middle Name:
Last Name:KRISHNASWAMI
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 1:1350 LOCUST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:724-929-6700
Mailing Address - Fax:
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-562-3292
Practice Address - Fax:412-281-2610
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028136E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009005100007Medicaid
PAD75959Medicare UPIN
PA0009005100007Medicaid