Basic Information
| Provider Information | |||||||||
| NPI: | 1497718803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IYER | ||||||||
| FirstName: | RAMAKRISHNAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2335 CHESTERFIELD AVE 202 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253041066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043462284 | ||||||||
| FaxNumber: | 3043466590 | ||||||||
| Practice Location | |||||||||
| Address1: | 2335 CHESTERFIELD AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253041066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043462284 | ||||||||
| FaxNumber: | 3043467470 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 12/15/2015 | ||||||||
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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 | 207RC0000X | WV13143 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 13143 | WV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207UN0901X | 13143 | WV | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology |
ID Information
| ID | Type | State | Issuer | Description | P01050055 | 01 | WV | MEDICARE RAILROAD | OTHER | 0087274000 | 05 | WV | MEDICAID |