Provider Demographics
NPI:1861639965
Name:SIVAD PRIMARY CARE AND ASSOCIATES P.C.
Entity type:Organization
Organization Name:SIVAD PRIMARY CARE AND ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O. / FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:S.
Authorized Official - Middle Name:ASKIA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN/ FAMILY PRACT
Authorized Official - Phone:803-318-5004
Mailing Address - Street 1:9019 GARNERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9540
Mailing Address - Country:US
Mailing Address - Phone:803-318-5004
Mailing Address - Fax:
Practice Address - Street 1:909 ALDER AVE
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1454
Practice Address - Country:US
Practice Address - Phone:253-240-9599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service