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Individual
SIVA AMBALAVANAN
Active
Individual
SIVA AMBALAVANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
74675
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000035826
ANTHEM
—
05
—
2102905
—
OH
01
—
2204490
AETNA
—
01
—
310821503030
CARE SOURCE
—
01
—
3108215037C16
UNITED MINE WORKERS
—
01
—
390005871
MEDICARE RAILROAD
—
01
—
D74675
HUMANA
—
Enumeration date
11/14/2005
Last updated
12/19/2024
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