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Individual

KIRAN IVATURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7250 CLEARVISTA DR STE 225, INDIANAPOLIS, IN 46256-5626
(317) 537-6088
(317) 537-6092
Mailing address
6983 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(317) 849-8350
(317) 576-6311

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01073768A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000869178
ANTHEM BCBS
IN
05
201108550
IN
Enumeration date
06/10/2010
Last updated
03/23/2021
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