| Sivimed Internal Medicine Assoc | |
|
141 Thomas Johnson Dr Ste 100 Frederick MD 21702-4509 | |
| (301) 228-9123 | |
| (855) 760-5009 |
| Full Name | Sivimed Internal Medicine Assoc |
|---|---|
| Speciality | Internal Medicine |
| Location | 141 Thomas Johnson Dr Ste 100, Frederick, Maryland |
| Authorized Official Name and Position | Usha Sivakumar (PHYSICIAN) |
| Authorized Official Contact | 3012289123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sivimed Internal Medicine Assoc 141 Thomas Johnson Dr Ste 100 Frederick MD 21702-4509 Ph: (301) 228-9123 | Sivimed Internal Medicine Assoc 141 Thomas Johnson Dr Ste 100 Frederick MD 21702-4509 Ph: (301) 228-9123 |
| NPI Number | 1033676143 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 1557697018 |
|---|---|
| Medicare Enrollment ID | O20190723000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033676143 | NPI | - | NPPES |
| 1053193193 | Other | MD | BOARD OF NURSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Usha Sivakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124001540 PECOS PAC ID: 4486730777 Enrollment ID: I20170619001083 |
| Provider Name | Sangita Basnet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053193193 PECOS PAC ID: 9133568967 Enrollment ID: I20240412003043 |
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