MEDICARE: INDU SIVARAMAN MD LLC

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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician

General Provider Information

NPI Number	:	1841146727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDU SIVARAMAN MD LLC

Provider Business Mailing Address
First Line	:	35040 CHARDON RD STE 105
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9027
Country	:	US
Telephone Number	:	440-766-3876
Fax Number	:	440-756-3876

Provider Business Practice Location Address
First Line	:	35040 CHARDON RD STE 105
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9027
Country	:	US
Telephone Number	:	440-766-3876
Fax Number	:	440-756-3876

Authorized Official
Title or Position	:	OWNER
Name	:	DR. INDU SIVARAMAN
Credential	:	MD
Telephone Number	:	440-666-2193

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	04/10/2026

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