Provider Demographics
NPI:1649497215
Name:VISH V.IYER MD, PC
Entity type:Organization
Organization Name:VISH V.IYER MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VISH
Authorized Official - Middle Name:VENKATESH
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-782-6800
Mailing Address - Street 1:30 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-1954
Mailing Address - Country:US
Mailing Address - Phone:412-782-6800
Mailing Address - Fax:412-781-2123
Practice Address - Street 1:30 HIGH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1954
Practice Address - Country:US
Practice Address - Phone:412-782-6800
Practice Address - Fax:412-781-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071771L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7745011Medicaid
PA056283Medicare ID - Type Unspecified