Provider Demographics
NPI:1134562879
Name:THIAGARAJASUBRAMANIAN, ASHWIN KRISHNAN (MD)
Entity type:Individual
Prefix:MR
First Name:ASHWIN
Middle Name:KRISHNAN
Last Name:THIAGARAJASUBRAMANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ASHWIN
Other - Middle Name:KRISHNAN
Other - Last Name:THIAGARAJASUBRAMANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:134 INDUSTRIAL PARK RD STE 1500
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8153
Mailing Address - Country:US
Mailing Address - Phone:724-850-6933
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:530 SOUTH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2775
Practice Address - Country:US
Practice Address - Phone:724-689-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD466255207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program