Provider Demographics
NPI:1699745760
Name:IYER, RAJALAKSHMI V (MD)
Entity type:Individual
Prefix:
First Name:RAJALAKSHMI
Middle Name:V
Last Name:IYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1378 NW 124TH ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8151
Mailing Address - Country:US
Mailing Address - Phone:515-288-6097
Mailing Address - Fax:
Practice Address - Street 1:1378 NW 124TH ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8151
Practice Address - Country:US
Practice Address - Phone:515-288-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81384207R00000X, 207RG0100X
IL036104236207RG0100X
IA39111207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A813840Medicaid
CA00A813840Medicare PIN
CA00A813840Medicaid