Organization
IYER PEDIATRIC CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJARAMAN S IYER M.D. (OWNER)
(219) 791-3613
Entity
Organization
Contact information
Practice address
4320 FIR ST, SUITE 208, EAST CHICAGO, IN 46312-3052
(219) 398-9265
(219) 398-9370
Mailing address
10006 TANGLEWOOD CT, MUNSTER, IN 46321-3836
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01055306A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200984240A
—
IN
Enumeration date
06/02/2010
Last updated
11/01/2010
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