MEDICARE: DR. RAJARAMAN SUBRAMANIAN IYER MD

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	208000000X	Pediatrics Physician	01055306	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	:	1538150842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAJARAMAN SUBRAMANIAN IYER MD

Provider Business Mailing Address
First Line	:	10006 TANGLEWOOD CT
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-3836
Country	:	US
Telephone Number	:	219-398-9265
Fax Number	:	219-398-9265

Provider Business Practice Location Address
First Line	:	4320 FIR ST
Second Line	:	STE 208
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-3052
Country	:	US
Telephone Number	:	219-398-9265
Fax Number	:	219-398-9370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	02/16/2011

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