=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841146727
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDU SIVARAMAN M.D.,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2026
-----------------------------------------------------
Last Update Date | 03/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35040 CHARDON RD STE 105
-----------------------------------------------------
City | WILLOUGHBY HILLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44094-9004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-766-3876
-----------------------------------------------------
Fax | 440-756-3876
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35040 CHARDON RD STE 105
-----------------------------------------------------
City | WILLOUGHBY HILLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44094-9004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-766-3876
-----------------------------------------------------
Fax | 440-756-3876
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. INDU SIVARAMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 440-666-2193
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0402X
-----------------------------------------------------
Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------