Ajanthan Sivagurunathan, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

210 North Lafayette
Providence Medical Center - South Lyon,
South Lyon, MI 48178

Phone

(248) 437-1744

Fax

(248) 437-3245

NPI assigned

May 23, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1285071860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NORTH LAFAYETTE",
            "address_2": "PROVIDENCE MEDICAL CENTER - SOUTH LYON,",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-1744",
            "fax_number": "248-437-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NORTH LAFAYETTE",
            "address_2": "PROVIDENCE MEDICAL CENTER - SOUTH LYON,",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "48178",
            "telephone_number": "248-437-1744",
            "fax_number": "248-437-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAGURUNATHAN",
        "first_name": "AJANTHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle N Shoup, PTA
• Diana Rebecca Silas, DO
• Silverback, Inc.
• Paul L Simon, DDS
• Robin Lynn-Pregitzer Simonton, DDS
• Karen Michelle Skrzypek, LMSW, CAADC
• Ladonna Slattery
• Amy Noelle Smith, LPC
• Kathryn Ansley Smith, PA-C
• Kenneth Smoot, AT, ATC

• Student in an Organized Health Care Education/Training Program in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.