Provider Demographics
NPI:1730282302
Name:MACHIRAJU, V R (MD)
Entity Type:Individual
Prefix:
First Name:V
Middle Name:R
Last Name:MACHIRAJU
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 1:5200 CENRE AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232
Mailing Address - Country:US
Mailing Address - Phone:412-623-3140
Mailing Address - Fax:412-623-6431
Practice Address - Street 1:5200 CENRE AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232
Practice Address - Country:US
Practice Address - Phone:412-623-3140
Practice Address - Fax:412-623-6431
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021564Y208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA65386704Medicaid
PA65386704Medicaid
PA059513GSOMedicare ID - Type Unspecified