Provider Demographics
NPI:1568622157
Name:SRIVASTAVA, PUSHKAR KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:PUSHKAR
Middle Name:KUMAR
Last Name:SRIVASTAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PUSHKAR
Other - Middle Name:GANESHPRASAD
Other - Last Name:SRIVASTAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 HAWKINS DRIVE
Mailing Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS UIHC
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-356-3568
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DRIVE
Practice Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS UIHC
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR8282208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics