Provider Demographics
NPI:1780685115
Name:IYER, VISH V (MD)
Entity type:Individual
Prefix:DR
First Name:VISH
Middle Name:V
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-1954
Mailing Address - Country:US
Mailing Address - Phone:412-782-6800
Mailing Address - Fax:412-781-2123
Practice Address - Street 1:30 HIGH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1954
Practice Address - Country:US
Practice Address - Phone:412-782-6800
Practice Address - Fax:412-781-2123
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071771L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG70811Medicare UPIN
PA056166Medicare ID - Type Unspecified
PA056166TDQMedicare PIN