Organization
THREE RIVERS PAIN MANAGEMENT ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHAKAR BABU MANNAM MD (OWNER)
(412) 203-1214
Entity
Organization
Contact information
Practice address
205 EASY ST STE 204, UNIONTOWN, PA 15401
(724) 812-5580
(724) 812-5682
Mailing address
736 W INGOMAR RD UNIT 116, INGOMAR, PA 15127-6604
(724) 812-5580
(724) 812-5682
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD426845
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109916
MEDICARE
PA
Enumeration date
10/19/2006
Last updated
08/12/2023
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