Individual
PREMA SIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8871 GORMAN RD STE 300, LAUREL, MD 20723-5877
(410) 498-3150
(410) 601-8886
Mailing address
8871 GORMAN RD STE 300, LAUREL, MD 20723-5877
(410) 498-3150
(410) 601-8886
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
186016
NY
207R00000X
Internal Medicine Physician
Primary
D66419
MD
Other
Enumeration date
05/30/2006
Last updated
04/04/2024
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