MEDICARE: DR. SIVAKUMAR JAIKUMAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	2005-00905	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00259530	OTHER	NC	RAILROAD

General Provider Information

NPI Number	:	1154345288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIVAKUMAR JAIKUMAR MD

Provider Business Mailing Address
First Line	:	143 W FRANKLIN ST
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-2539
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4207 LAKE BOONE TRL STE 220
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6685
Country	:	US
Telephone Number	:	919-784-1410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	11/22/2022

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