Provider Demographics
NPI:1932188927
Name:SAWARDEKAR, ARUN S (MD)
Entity Type:Individual
Prefix:
First Name:ARUN
Middle Name:S
Last Name:SAWARDEKAR
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 1:726 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-6102
Mailing Address - Country:US
Mailing Address - Phone:724-458-7586
Mailing Address - Fax:
Practice Address - Street 1:635 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1156
Practice Address - Country:US
Practice Address - Phone:724-458-8044
Practice Address - Fax:724-458-1522
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021089E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006094750001Medicaid
PAE77419Medicare UPIN