Provider Demographics
NPI:1801878368
Name:IYER, SATHYAN V (MD)
Entity type:Individual
Prefix:DR
First Name:SATHYAN
Middle Name:V
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 1:851 GOODYEAR AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1133
Mailing Address - Country:US
Mailing Address - Phone:256-413-6000
Mailing Address - Fax:256-413-6016
Practice Address - Street 1:851 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1133
Practice Address - Country:US
Practice Address - Phone:256-413-6000
Practice Address - Fax:256-413-6016
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.14048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051082496OtherBLUE CROSS BLUE SHIELD AL
AL080020650OtherRAILROAD MEDICARE
AL116983Medicaid
AL0110847OtherUNITED HEALTHCARE
AL102I085540Medicare PIN
AL116983Medicaid