Provider Demographics
NPI:1013413152
Name:JAWAHAR, ARAVINTH PRASANTH (MD)
Entity type:Individual
Prefix:DR
First Name:ARAVINTH PRASANTH
Middle Name:
Last Name:JAWAHAR
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 1:4, ANNAI ILLAM, TEPPAKULAM NEW COLONY, KAMARAJAR ROAD
Mailing Address - Street 2:
Mailing Address - City:MADURAI
Mailing Address - State:TAMIL NADU
Mailing Address - Zip Code:625009
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-6739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4841842080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine