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General NPI Number Information
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NPI Number | 1558882217
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Entity Type | Individual
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Provider Name | SRINIVASA VENKATA SIVA KUMAR KASINA MBBS
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Gender | Male
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 4720 WASHINGTON RD
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City | EVANS
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State | GA
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Zip | 30809-5875
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Country | US
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Telephone | 706-854-3410
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 WASHINGTON RD
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City | EVANS
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State | GA
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Zip | 30809-5875
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | R-11714
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | E-15199
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 105374
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License Number State | GA
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