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Individual
DR. INDRA SRIRAM
Active
Individual
DR. INDRA SRIRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
01040404
IN
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
MMD.36130 MD
SC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01040404
IN
Other
Enumeration date
06/22/2005
Last updated
07/10/2014
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