Provider Demographics
NPI:1730119462
Name:SIVAN, VALAPARAMBIL K (MD)
Entity Type:Individual
Prefix:
First Name:VALAPARAMBIL
Middle Name:K
Last Name:SIVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-1133
Practice Address - Street 1:9106 PHILADELPHIA RD
Practice Address - Street 2:SUITE 214
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4329
Practice Address - Country:US
Practice Address - Phone:410-238-0881
Practice Address - Fax:410-238-0944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0023425207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7795VK 36323001OtherCAREFIRST
DCW247 0001OtherCAREFIRST
DCW247 0001OtherCAREFIRST
MD7795Medicare PIN