Individual
ARJUNAN GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD418208
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD418208
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD428208
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019674240
—
PA
01
—
072667EJL
MEDICARE PTAN
PA
Enumeration date
08/19/2006
Last updated
06/01/2023
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