Healthcare Provider Details

I. General information

NPI: 1134547037
Provider Name (Legal Business Name): ANITA SIVAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2014
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10255 COMMERCE DR STE 212
CARMEL IN
46032-7433
US

IV. Provider business mailing address

10255 COMMERCE DR STE 212
CARMEL IN
46032-7433
US

V. Phone/Fax

Practice location:
  • Phone: 317-721-1521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number02005605A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: