1053383224 NPI number — MRS. HEMLATA MOTURI M.D.

Table of content: MRS. HEMLATA MOTURI M.D. (NPI 1053383224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053383224 NPI number — MRS. HEMLATA MOTURI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOTURI
Provider First Name:
HEMLATA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1053383224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 E NORTH AVE
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-359-3426
Provider Business Mailing Address Fax Number:
412-359-6974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 E NORTH AVE
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-359-3426
Provider Business Practice Location Address Fax Number:
412-359-6974
Provider Enumeration Date:
02/02/2006

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: 207RE0101X , with the licence number:  MD070677L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1008301310001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138541 . This is a "UNISON / MEDPLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2288256 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1394089 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 233043491 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3004648000 . This is a "WEST VIRGINIA MEDICAID" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: P00008668 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 247177 . This is a "HEALTHAMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2992534 . This is a "AETNA USHC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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