Provider Demographics
NPI:1962632158
Name:SVS OPHTHALMOLOGY, LLC
Entity Type:Organization
Organization Name:SVS OPHTHALMOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:VISHNU
Authorized Official - Last Name:SUNDARAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-858-3634
Mailing Address - Street 1:200 W 103RD ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1092
Mailing Address - Country:US
Mailing Address - Phone:317-817-1254
Mailing Address - Fax:317-817-1027
Practice Address - Street 1:200 W 103RD ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1092
Practice Address - Country:US
Practice Address - Phone:317-817-1254
Practice Address - Fax:317-817-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065082A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty