Individual
MARY VAJRAVELU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4401 PENN AVE, PITTSBURGH, PA 15224-1334
(412) 692-5170
Mailing address
4401 PENN AVE, FACULTY PAVILION 6TH FLOOR, PITTSBURGH, PA 15224
(412) 692-5170
(412) 692-5834
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MT201169
PA
2080P0205X
Pediatric Endocrinology Physician
Primary
MD454379
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034873410002
—
PA
Enumeration date
06/21/2012
Last updated
08/19/2021
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