Individual
DR. SANKARAVADIVU SIVASAILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9114 PHILADELPHIA RD, SUITE 208, BALTIMORE, MD 21237-4317
(410) 687-5300
(410) 682-4418
Mailing address
9114 PHILADELPHIA RD, SUITE 208, BALTIMORE, MD 21237-4317
(410) 687-5300
(410) 682-4418
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
D45530
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31421100
—
MD
Enumeration date
09/09/2005
Last updated
06/09/2011
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