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General NPI Number Information
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NPI Number | 1619965043
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Entity Type | Individual
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Provider Name | SIVA MARAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 705 N HIGH ST SUITE A
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City | MORRISTOWN
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State | TN
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Zip | 37814-3876
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Country | US
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Telephone | 423-415-3310
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Fax | 423-587-9898
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Provider Business Mailing Address
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Address Line | 705 N HIGH ST SUITE A
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City | MORRISTOWN
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State | TN
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Zip | 37814-3876
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Country | US
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Telephone | 423-415-3310
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Fax | 423-587-9898
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MD0000023962
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 023962
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License Number State | TN
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