Healthcare Provider Details

I. General information

NPI: 1548674583
Provider Name (Legal Business Name): KALAIVANI SIVAKUMAR M.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALAIVANI NATARAJAN

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982265 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2265
US

IV. Provider business mailing address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-8888
  • Fax:
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number10524
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: