Provider Demographics
NPI:1902800493
Name:MOORTHY, RAMANA S (MD)
Entity type:Individual
Prefix:
First Name:RAMANA
Middle Name:S
Last Name:MOORTHY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10585 N MERIDIAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1066
Mailing Address - Country:US
Mailing Address - Phone:317-571-1501
Mailing Address - Fax:317-571-4806
Practice Address - Street 1:12794 HAMILTON CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5422
Practice Address - Country:US
Practice Address - Phone:317-571-1501
Practice Address - Fax:317-571-4806
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2025-05-15
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Provider Licenses
StateLicense IDTaxonomies
IN01037732A207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201128590Medicaid
IN088990BMedicare PIN
IN201128590Medicaid
IN263670002Medicare PIN
INP01276828Medicare PIN