Provider Demographics
NPI:1275531899
Name:IYER, INDIRESHA RAMACHANDRA (MD)
Entity Type:Individual
Prefix:
First Name:INDIRESHA
Middle Name:RAMACHANDRA
Last Name:IYER
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 1:224 W EXCHANGE ST STE 225
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1726
Mailing Address - Country:US
Mailing Address - Phone:440-914-0018
Mailing Address - Fax:
Practice Address - Street 1:224 W EXCHANGE ST STE 225
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1726
Practice Address - Country:US
Practice Address - Phone:330-344-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35090803207RC0000X
OHPENDING207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000292339OtherANTHEM BLUE CROSS
OH2437081Medicaid
KY64068323Medicaid
OH000000731990OtherANTHEM
KY0571206Medicare PIN
KY0608106Medicare PIN
KYP00023115Medicare PIN
KY0710602Medicare PIN
KY0710304Medicare PIN
OH000000731990OtherANTHEM
OH2437081Medicaid
OHH029391Medicare PIN
KYH81791Medicare UPIN