Provider Demographics
NPI:1427098797
Name:PAWAR, SURENDRA V (MD)
Entity type:Individual
Prefix:
First Name:SURENDRA
Middle Name:V
Last Name:PAWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ACEE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065
Mailing Address - Country:US
Mailing Address - Phone:800-223-5544
Mailing Address - Fax:724-294-3206
Practice Address - Street 1:1301 CARLISLE ST
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065
Practice Address - Country:US
Practice Address - Phone:721-334-4774
Practice Address - Fax:724-334-4776
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022019E2085B0100X, 2085N0904X, 2085P0229X, 2085R0202X, 2085R0204X, 2085U0001X
WY16397C2085R0202X
ND181112085R0202X
GUMTL-2023-0212085R0202X
GUMC-1882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0764427Medicaid
PA165603OtherHIGHMARK
PA165603OtherHIGHMARK
PA0764427Medicaid