Provider Demographics
NPI:1417521345
Name:SIVARAJ, KRISHAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KRISHAN
Middle Name:
Last Name:SIVARAJ
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MACNIDER HALL CB 7005
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7005
Mailing Address - Country:US
Mailing Address - Phone:919-966-1043
Mailing Address - Fax:919-843-2356
Practice Address - Street 1:100 EASTOWNE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2286
Practice Address - Country:US
Practice Address - Phone:984-974-4462
Practice Address - Fax:919-843-0740
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1417521345208M00000X
NC304964390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program