Provider Demographics
NPI:1518901123
Name:JANARDHANAN, RAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:JANARDHANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:T
Other - Middle Name:JAN
Other - Last Name:RAVI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3285 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2829
Mailing Address - Country:US
Mailing Address - Phone:412-318-0075
Mailing Address - Fax:412-318-0081
Practice Address - Street 1:3285 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-318-0075
Practice Address - Fax:412-318-0081
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD296296E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008667120004Medicaid
PA103008OtherBLUE CROSS AND BLUE SHIEL
PA2173970OtherUS HEALTHCARE
PA100017049OtherUNITED HEALTHCARE
PA154886OtherHEALTH AMERICA
PA0008667120004Medicaid