Individual
DR. MYLAPPAN SELVARAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 NORTH ST, PITTSFIELD, MA 01201-4147
(724) 545-9774
(724) 543-2945
Mailing address
109 WINTERWOOD DR, BUTLER, PA 16001-2833
(724) 679-4192
(724) 482-1162
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
42361
MA
207RC0000X
Cardiovascular Disease Physician
MD-028840-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01 1091654
—
PA
01
—
SE127889
BG & BS
PA
Enumeration date
06/16/2005
Last updated
10/23/2020
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