Provider Demographics
NPI:1750327516
Name:SAHU, PAWAN K (MD)
Entity Type:Individual
Prefix:
First Name:PAWAN
Middle Name:K
Last Name:SAHU
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 1:1 CORNERSTONE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1318
Mailing Address - Country:US
Mailing Address - Phone:215-891-9400
Mailing Address - Fax:215-891-9361
Practice Address - Street 1:1 CORNERSTONE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1318
Practice Address - Country:US
Practice Address - Phone:215-891-9400
Practice Address - Fax:215-891-9361
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053553L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG23973Medicare UPIN