Provider Demographics
NPI:1649436122
Name:KAKIVAYI, SUMANA (MD)
Entity type:Individual
Prefix:DR
First Name:SUMANA
Middle Name:
Last Name:KAKIVAYI
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 1:113 SEATON CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-7200
Mailing Address - Country:US
Mailing Address - Phone:813-856-3196
Mailing Address - Fax:
Practice Address - Street 1:113 SEATON CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-7200
Practice Address - Country:US
Practice Address - Phone:813-856-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD30381282N00000X
ALMD.30381207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No282N00000XHospitalsGeneral Acute Care Hospital