Individual
DR. GIRIDHAR MYSORE SHIVARAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-2166
Mailing address
4800 SAND POINT WAY NE, M/S MA.7.220, PO BOX 5371, SEATTLE, WA 98105-3901
(206) 987-2166
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
MD60180267
WA
2085R0202X
Diagnostic Radiology Physician
MD60180267
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD60180267
WA
Other
Enumeration date
08/08/2008
Last updated
07/27/2013
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