Provider Demographics
NPI:1801846258
Name:SIVARUBAN, KAVERI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAVERI
Middle Name:
Last Name:SIVARUBAN
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 1:11875 SHENANDOAH TRCE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7115
Mailing Address - Country:US
Mailing Address - Phone:513-560-2515
Mailing Address - Fax:
Practice Address - Street 1:8139 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3152
Practice Address - Country:US
Practice Address - Phone:513-474-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083580S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2462035Medicaid
OH2462035Medicaid
OHH066421Medicare PIN
OH2462035Medicaid
OHH99411Medicare UPIN