MEDICARE: SIVARAMAKRIS SRIDHAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	8688	AZ
2	207RC0000X	Cardiovascular Disease Physician	8688	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750380135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIVARAMAKRIS SRIDHAR M.D.

Provider Business Mailing Address
First Line	:	1331 N 7TH ST
Second Line	:	SUITE 400
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2754
Country	:	US
Telephone Number	:	602-277-6181
Fax Number	:	602-253-6059

Provider Business Practice Location Address
First Line	:	1331 N 7TH ST
Second Line	:	SUITE 400
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2754
Country	:	US
Telephone Number	:	602-277-6181
Fax Number	:	602-253-6059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	09/11/2025

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