Provider Demographics
NPI:1447632336
Name:SIVARAJAH, MATHAVAN (MD)
Entity type:Individual
Prefix:DR
First Name:MATHAVAN
Middle Name:
Last Name:SIVARAJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6778 GEORGETOWN LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-2173
Mailing Address - Country:US
Mailing Address - Phone:216-387-5766
Mailing Address - Fax:
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:216-444-2568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1340192080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine