Individual
MAURAN SIVANANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5111 AUTO CLUB DR, SUITE 112, DEARBORN, MI 48126-2749
(313) 317-2000
Mailing address
5111 AUTO CLUB DR, SUITE 112, DEARBORN, MI 48126-2749
(313) 317-2000
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
5101021263
MI
Other
Enumeration date
05/04/2011
Last updated
01/30/2017
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