Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 2011-01418 | NC |
N | 2080P0202X | Pediatric Cardiologist | MD-43679 | IA |
NPI | 1043482912 |
---|---|
Provider Name | Dr. Bijoy Damodaran Thattaliyath |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 11/08/2016 |