Provider Demographics
NPI:1154525582
Name:INDIRA, THIRUVALAM P (MD)
Entity type:Individual
Prefix:DR
First Name:THIRUVALAM
Middle Name:P
Last Name:INDIRA
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:THIRUVALAM
Other - Middle Name:
Other - Last Name:INDIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:154 E LEMON ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4956
Mailing Address - Country:US
Mailing Address - Phone:717-468-3724
Mailing Address - Fax:
Practice Address - Street 1:154 E LEMON ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4956
Practice Address - Country:US
Practice Address - Phone:717-468-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054347L207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine