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Contact Information

SIVA AMBALAVANAN, MD
500 LINCOLN PARK BLVD
SUITE 100
KETTERING, OH45429-6410
 Phone: 937-222-3118
 Fax: 937-222-1436
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SIVA AMBALAVANAN · (Male)

NPI # 1346222643
Status Active
Credentials MD
Entity Individual
Enumeration date 11/14/2005
Last updated 12/19/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OH License # 74675
  • OH Medicaid 2102905
  • Other 2204490 AETNA
  • Other 000000035826 ANTHEM
  • Other 310821503030 CARE SOURCE
  • Other D74675 HUMANA
  • Other 390005871 MEDICARE RAILROAD
  • Other 390005871 UHC
  • Other 3108215037C16 UNITED MINE WORKERS
Hospital affiliation(s)
  • GRANDVIEW HOSPITAL & MEDICAL CENTER - (Acute Care)
    405 GRAND AVENUE
    DAYTON, OH 45405
  • KETTERING MEDICAL CENTER - SYCAMORE - (Acute Care)
    4000 MIAMISBURG-CENTERVILLE ROAD
    MIAMISBURG, OH 45342
  • MIAMI VALLEY HOSPITAL - (Acute Care)
    ONE WYOMING STREET
    DAYTON, OH 45409
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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