Provider Demographics
NPI:1275846370
Name:SIVARAMAN, INDU (MD)
Entity Type:Individual
Prefix:DR
First Name:INDU
Middle Name:
Last Name:SIVARAMAN
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 1:35040 CHARDON RD
Mailing Address - Street 2:STE 110
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9004
Mailing Address - Country:US
Mailing Address - Phone:440-666-2193
Mailing Address - Fax:
Practice Address - Street 1:35040 CHARDON RD STE 110
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9004
Practice Address - Country:US
Practice Address - Phone:440-946-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-17
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH351207882084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program