Individual
LAKSHMANA RAO AYYAGARI
Active
Individual
LAKSHMANA RAO AYYAGARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036054745
IL
207RC0000X
Cardiovascular Disease Physician
Primary
4301106360
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036054745
MEDICAL LICENSE
ID
01
—
036054745
IPA ID#
IL
01
—
364025739
TAX ID
—
01
—
4301106360
STATE MEDICAL LICENSE
MI
01
—
690280
BCBS GROUP ID#
IL
Enumeration date
07/31/2006
Last updated
03/07/2023
Update your record
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