Individual
DR. BALARAM KRISHNA JAGANNAYAKULU HANUMANTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104-4206
(215) 662-7355
(215) 349-8444
Mailing address
1 CONVENTION AVE, PHILADELPHIA, PA 19104
(585) 485-3455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD484142
PA
207RC0000X
Cardiovascular Disease Physician
MD484142
PA
Other
Enumeration date
07/12/2016
Last updated
03/26/2025
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