Provider Demographics
NPI:1932515103
Name:NELLAIYAPPAN, MADHAN (MD)
Entity Type:Individual
Prefix:
First Name:MADHAN
Middle Name:
Last Name:NELLAIYAPPAN
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 1:320 EAST NORTH AVENUE, ALLEGHENY GENERAL HOSPITAL,
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 NE MOTHER JOSEPH PL STE 400
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3290
Practice Address - Country:US
Practice Address - Phone:360-514-4444
Practice Address - Fax:360-514-6530
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT207083390200000X
WAMD61229890207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program