Individual
DR. SIVA AMBALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.P.H., D.O.
Contact information
Practice address
1005 N GLEBE RD STE 160, ARLINGTON, VA 22201
(571) 492-3045
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102205174
VA
Other
Enumeration date
04/13/2012
Last updated
09/29/2022
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