Provider Demographics
NPI:1538139134
Name:BERIWAL, SUSHIL (MD)
Entity Type:Individual
Prefix:
First Name:SUSHIL
Middle Name:
Last Name:BERIWAL
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 1:314 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4737
Mailing Address - Country:US
Mailing Address - Phone:412-359-3400
Mailing Address - Fax:412-359-3981
Practice Address - Street 1:314 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4737
Practice Address - Country:US
Practice Address - Phone:412-359-3400
Practice Address - Fax:412-359-3981
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4206322085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009442120002Medicaid
WV3810001952Medicaid
PA1618489OtherHIGHMARK BS
OH2583771Medicaid
PA1009442120003Medicaid
PA11350057OtherCAQH
PA1009442120001Medicaid
PA1009442120004Medicaid
PAP00185093Medicare PIN
PA11350057OtherCAQH
PA1009442120002Medicaid