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General NPI Number Information
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NPI Number | 1831466796
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Entity Type | Individual
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Provider Name | PRAVEEN KUMAR CONJEEVARAM SELVAKUMAR M.D.,
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Gender | Male
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE DESK A11
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-6003
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Fax | 216-445-8241
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE DESK A11
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-6003
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Fax | 216-445-8241
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 57.024051
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 0101268263
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301098413
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License Number State | MI
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