MEDICARE: INDIANA HEART ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	50003647A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124078050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANA HEART ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 633711
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-3711
Country	:	US
Telephone Number	:	317-621-8666
Fax Number	:	317-621-8604

Provider Business Practice Location Address
First Line	:	1400 N RITTER AVE
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-3051
Country	:	US
Telephone Number	:	317-355-1234
Fax Number	:	317-355-1502

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAMARAO YELETI
Credential	:	MD
Telephone Number	:	317-621-8666

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/14/2008

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