Provider Demographics
NPI:1891792099
Name:JOHN, CHERIAN (MD)
Entity type:Individual
Prefix:
First Name:CHERIAN
Middle Name:
Last Name:JOHN
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 1:560 STEUBENVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-8539
Mailing Address - Country:US
Mailing Address - Phone:724-947-5350
Mailing Address - Fax:740-947-0206
Practice Address - Street 1:560 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-8552
Practice Address - Country:US
Practice Address - Phone:724-947-5053
Practice Address - Fax:724-947-0206
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033648E207R00000X, 207RC0000X
WV14686207R00000X, 207RC0000X
OH35054409J207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0698580Medicaid
WVP00011255OtherRR MEDICARE
PA0010024670008Medicaid
WV0085888000Medicaid
PAP00011256OtherRR MEDICARE
OHP00330359OtherRR MEDICARE
WV0890905Medicare PIN
OH4186375Medicare PIN
PA020406PK7Medicare PIN
OHP00330359OtherRR MEDICARE
A72418Medicare UPIN
WVP00011255OtherRR MEDICARE
WV0085888000Medicaid
OH4186374Medicare PIN
OH0890906Medicare PIN