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General NPI Number Information
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NPI Number | 1962632158
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Entity Type | Organization
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Legal Business Name | SVS OPHTHALMOLOGY, LLC
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 200 W 103RD ST SUITE 1000
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1092
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Country | US
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Telephone | 317-817-1254
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Fax | 317-817-1027
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Provider Business Mailing Address
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Address Line | 200 W 103RD ST SUITE 1000
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1092
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Country | US
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Telephone | 317-817-1254
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Fax | 317-817-1027
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Authorized Official
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Title or Position | SINGLE MEMBER
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Name | DR. SEEMA VISHNU SUNDARAM
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Credential | MD
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Telephone | 317-858-3634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01065082A
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License Number State | IN
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