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NPI Code Detail

MEDICARE: SUSIL SIVARAMAN M.D.

MEDICARE: SUSIL SIVARAMAN M.D.
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
1208M00000XHospitalist Physician17288NV
2207R00000XInternal Medicine Physician17288NV

General Provider Information

NPI Number : 1437577327
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSIL SIVARAMAN M.D.
Provider Business Mailing Address
First Line : 8600 W GILMORE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7684
Country : US
Telephone Number : 702-682-5232
Fax Number :
Provider Business Practice Location Address
First Line : 6900 N PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-682-5232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2014
Last Update Date : 08/03/2023

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Directions to “ SUSIL SIVARAMAN M.D.” Practice Location

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