Provider Demographics
NPI:1629078613
Name:CHOLAPRANEE, REWAT (MD)
Entity Type:Individual
Prefix:DR
First Name:REWAT
Middle Name:
Last Name:CHOLAPRANEE
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 1:135 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5447
Mailing Address - Country:US
Mailing Address - Phone:412-367-3077
Mailing Address - Fax:412-367-4302
Practice Address - Street 1:135 CUMBERLAND RD
Practice Address - Street 2:SUITE 204
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5447
Practice Address - Country:US
Practice Address - Phone:412-367-3077
Practice Address - Fax:412-367-4302
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-31
Last Update Date:2007-11-28
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
PAMD036980L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009546910003Medicaid
PA104718Medicare PIN
PA0009546910003Medicaid