Individual
DR. AYYAVOO NANDHAKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1376 BUCKTAIL RD, SAINT MARYS, PA 15857-3212
(814) 781-6565
(814) 781-1985
Mailing address
803 STONEHEDGE MEADOWS DR, RIDGWAY, PA 15853-9745
(814) 772-6514
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD047983L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD047983L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000067822
HIGHMARK
PA
05
—
0014734060004
—
PA
01
—
050002703
RAILROAD MEDICARE
PA
Enumeration date
02/10/2007
Last updated
05/12/2008
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