Individual
KIRAN IVATURI
Active
Individual
KIRAN IVATURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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