Provider Demographics
NPI:1548207491
Name:THIAGARAJAH, SIVA (MD)
Entity Type:Individual
Prefix:
First Name:SIVA
Middle Name:
Last Name:THIAGARAJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PETER JEFFERSON PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-220-8620
Mailing Address - Fax:434-220-8625
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 190
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-220-8620
Practice Address - Fax:434-220-8625
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024461207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006209483Medicaid
VA070498000OtherSOUTHERN HEALTH
VA309085OtherBC BS