Individual
SIRUMUGAI M SARAVANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1116 N 16TH ST STE A, LAFAYETTE, IN 47904-2119
(765) 448-8000
(765) 448-8807
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01064164A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000531180
ANTHEM PROVIDER NUMBER
IN
05
—
200871700
—
IN
Enumeration date
07/12/2007
Last updated
03/05/2021
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