Sriram, Indra

Sriram, Indra is an individual health care provider with primary practice located at 168 Carolina Ridge Dr , Columbia SC 29229-7396. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is her primary health care specialty. Sriram, Indra can be contacted via phone (260) 602-4645.

Contact Information

Primary practice address
168 Carolina Ridge Dr Columbia SC 29229-7396
Phone: (260) 602-4645
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X 01040404 Indiana
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 01040404 Indiana
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X MMD.36130 MD South Carolina

Profile Details

NPI number 1790781938
LBN Legal business name Sriram, Indra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jul 10th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790781938 NPPES
Indiana MEDICAID 100439910

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