Thangudu, Pavan K

Thangudu, Pavan K is an individual health care provider with primary practice located at 4300 Londonderry Rd , Harrisburg PA 17109-5317. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Thangudu, Pavan K can be contacted via phone (717) 231-8772.

Contact Information

Primary practice address
4300 Londonderry Rd Harrisburg PA 17109-5317
Phone: (717) 231-8772
Fax: (717) 231-8435
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD457573 Pennsylvania
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X R1661 Texas

Profile Details

NPI number 1679898829
LBN Legal business name Thangudu, Pavan K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2010
Last updated Aug 8th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679898829 NPPES
Pennsylvania MEDICAID 103118689

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