Theethaye Ittiara MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301031889 Issued in MI

Legal business name

THEETHAYE ITTIARA MD PC

Practice address

142 E Maumee Street Suite 3
Adrian, MI 49221-3619

Phone

(517) 263-5810

NPI assigned

Mar 1, 2012

Last updated

Mar 1, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Theethaye L IttiaraNPI 1174585475

Title

MD

Phone

(517) 263-5810

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theethaye Lonappan Ittiara, M.D

  • Psychiatry Physician
  • Adrian, MI
  • NPI 1174585475
  Authorized official Same address or phone
• Marislene Delva

  • Physician Assistant
  • Detroit, MI
  • NPI 1144603721
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1881968394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 E MAUMEE STREET SUITE 3",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213619",
            "telephone_number": "517-263-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E MAUMEE STREET SUITE 3",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213619",
            "telephone_number": "517-263-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEETHAYE ITTIARA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "ITTIARA",
        "authorized_official_first_name": "THEETHAYE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "517-263-5810"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301031889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Healing Project, LLC
• The Mindful Matriarch L.L.C
• The Pharm of Michigan (Pharm Pharmacy 6102)
• The Potent Planner LLC
• The Young Men's Christian Association of Lenawee County
• Theethaye L. Ittiara, M.D., P.C.
• Therasys, Inc.
• Thomas W. Muldary, PH.D. and Patricia M. Muldary, PH.D. PC
• Annah Thomas-Dull
• Patrick Thomas

• Psychiatry Physician in Adrian, MI
• Providers in Adrian, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.