Provider Demographics
NPI:1962402578
Name:A SIVAN PILLAI MD PA
Entity type:Organization
Organization Name:A SIVAN PILLAI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:A
Authorized Official - Middle Name:SIVAN
Authorized Official - Last Name:PILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-777-9626
Mailing Address - Street 1:915 SETON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1817
Mailing Address - Country:US
Mailing Address - Phone:301-777-9626
Mailing Address - Fax:901-777-7152
Practice Address - Street 1:915 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1817
Practice Address - Country:US
Practice Address - Phone:301-777-9626
Practice Address - Fax:901-777-7152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD13233208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1448650005OtherCIGNA
E528OtherCAPITALCARE
WV0129327000Medicaid
MD6738ASOtherBLUECROSS/BLUESHIELD
022507OtherTRAVELER'S MEDICARE
220773OtherMDIPA
0458147OtherUNITED MINE WORKERS
PA42495OtherBLUECROSS/BLUESHIELD
533040OtherMAMSI
022507OtherTRAVELER'S MEDICARE
WV0129327000Medicaid