Adumala, Pradeep

Adumala, Pradeep is an sole proprietor health care provider with primary practice located at 564 W Broad St , Hazleton PA 18201-6108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Adumala, Pradeep can be contacted via phone (570) 501-6400.

Contact Information

Primary practice address
564 W Broad St Hazleton PA 18201-6108
Phone: (570) 501-6400
Fax: (570) 453-2352
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA09519900 New Jersey
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD468261 Pennsylvania

Profile Details

NPI number 1770983272
LBN Legal business name Adumala, Pradeep
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 3rd, 2014
Last updated Feb 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770983272 NPPES
Pennsylvania MEDICAID 103660812-0001
Pennsylvania MEDICAID 0415502

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