Provider Demographics
NPI:1932139326
Name:IYER, VENKAT R (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKAT
Middle Name:R
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:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:612 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5041
Practice Address - Country:US
Practice Address - Phone:757-547-9294
Practice Address - Fax:757-213-9374
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249283207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
3680623OtherCIGNA
VA1932139326OtherVHN
VA1932139326OtherMEDCOST
VA1932139326OtherTRICARE
NC5917947Medicaid
VA1932139326OtherCOVENTRY
VA1932139326OtherANTHEM BCBS
VA1932139326Medicaid
NC5917947Medicaid
VAP009971161Medicare PIN