Provider Demographics
NPI:1902869381
Name:PRABHAKARAN, DILIP M (MD)
Entity type:Individual
Prefix:DR
First Name:DILIP
Middle Name:M
Last Name:PRABHAKARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MADATHIL
Other - Middle Name:
Other - Last Name:DILIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3030
Mailing Address - Fax:412-359-3060
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3030
Practice Address - Fax:412-359-3060
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441167208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025575770002Medicaid
AZI34014Medicare UPIN
PA1025575770002Medicaid