1891792099 NPI number — CHERIAN JOHN MD

Table of content: CHERIAN JOHN MD (NPI 1891792099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891792099 NPI number — CHERIAN JOHN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHN
Provider First Name:
CHERIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891792099
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
560 STEUBENVILLE PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURGETTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15021-8539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-947-5350
Provider Business Mailing Address Fax Number:
740-947-0206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
560 STEUBENVILLE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURGETTSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15021-8552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-947-5053
Provider Business Practice Location Address Fax Number:
724-947-0206
Provider Enumeration Date:
07/01/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD033648E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 14686 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 35054409J , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: MD033648E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 14686 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 35054409J , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0698580 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00011255 . This is a "RR MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0010024670008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0085888000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00011256 . This is a "RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00330359 . This is a "RR MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".