Basic Information
| Provider Information | |||||||||
| NPI: | 1467493791 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IYER | ||||||||
| FirstName: | RAVI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28121 DECLARATION RD | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485961113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22341 W 8 MILE RD | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482191217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3133878700 | ||||||||
| FaxNumber: | 3133877665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 05/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301082017 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.