Provider Demographics
NPI:1841273539
Name:SWAMY, SIVAPPA S (MD)
Entity type:Individual
Prefix:
First Name:SIVAPPA
Middle Name:S
Last Name:SWAMY
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 1:2205 BELTLINE RD SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3617
Mailing Address - Country:US
Mailing Address - Phone:256-306-4000
Mailing Address - Fax:256-306-4106
Practice Address - Street 1:2205 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3617
Practice Address - Country:US
Practice Address - Phone:256-306-4000
Practice Address - Fax:256-306-4106
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000123292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51529186OtherBCBS
D08202Medicare UPIN
ALD515529615WAMedicare ID - Type Unspecified