Individual
DR. SHRAVAN SIVAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
(603) 640-1228
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5491
(617) 667-7000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
1018967
MA
2084N0400X
Neurology Physician
Primary
33707
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
03/31/2020
Last updated
12/16/2025
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