Provider Demographics
NPI:1982736674
Name:IYER, MEENAKSHI NAGARAJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MEENAKSHI
Middle Name:NAGARAJAN
Last Name:IYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 PADDOCKS PKWY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-9119
Mailing Address - Country:US
Mailing Address - Phone:678-735-5300
Mailing Address - Fax:678-735-5305
Practice Address - Street 1:3350 PADDOCKS PKWY
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9119
Practice Address - Country:US
Practice Address - Phone:678-735-5300
Practice Address - Fax:678-735-5305
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.091546207RE0101X
GA86147207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3093692Medicaid
KY7100140850Medicaid
OHIY4299131Medicare PIN