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Individual

DR. VIJAI SATHYAN TIVAKARAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4160 LITTLE YORK RD, SUITE 20, DAYTON, OH 45414-5800
(937) 454-9527
(937) 454-9532
Mailing address
4160 LITTLE YORK RD, SUITE 20, DAYTON, OH 45414-5800
(937) 454-9527
(937) 454-9532

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
219747
NY
207RC0000X
Cardiovascular Disease Physician
Primary
34008775
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3132676
OH
Enumeration date
03/17/2006
Last updated
11/17/2020
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