Provider Demographics
NPI:1851181176
Name:EADARA, SAI NIVED
Entity type:Individual
Prefix:
First Name:SAI NIVED
Middle Name:
Last Name:EADARA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 JEFFERSON STREET, P.O. BOX 607, SOUTH CENTRAL REGI
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39441
Mailing Address - Country:US
Mailing Address - Phone:601-426-5128
Mailing Address - Fax:
Practice Address - Street 1:1220 JEFFERSON STREET, SOUTH CENTRAL REGIONAL MEDICAL C
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440
Practice Address - Country:US
Practice Address - Phone:601-426-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program