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Individual
SUBBURAMAN SIVAKUMAR
Active
Individual
SUBBURAMAN SIVAKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D D.O
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SS065284
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108268931
BLUE CROSS BLUE SHIELD
MI
01
—
2310443
CIGNA
MI
01
—
2604488
AETNA
MI
05
—
4301165
—
MI
Enumeration date
08/03/2005
Last updated
09/20/2021
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