Provider Demographics
NPI:1578536223
Name:JASWAL, SUMAN S (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN
Middle Name:S
Last Name:JASWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 N BROAD ST
Mailing Address - Street 2:3RD FLR.
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:215-463-5333
Mailing Address - Fax:215-463-8085
Practice Address - Street 1:525 JAMESTOWN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128
Practice Address - Country:US
Practice Address - Phone:215-482-1607
Practice Address - Fax:215-482-3768
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD074200L207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101253174Medicaid
PA090873GT6Medicare PIN