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Individual
DR. SHIVARAJAN MANICKAVASAGAM AMUDHAVALLI
Active
Individual
DR. SHIVARAJAN MANICKAVASAGAM AMUDHAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
0436759
KS
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
201029319
MO
208000000X
Pediatrics Physician
P23802
MD
Other
Enumeration date
12/05/2008
Last updated
07/18/2026
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