Provider Demographics
NPI:1063667772
Name:DAVE TRIVEDI, SHILPA SAMIR (MD)
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:SAMIR
Last Name:DAVE TRIVEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220, KIT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560
Mailing Address - Country:US
Mailing Address - Phone:910-584-5003
Mailing Address - Fax:
Practice Address - Street 1:1125 HATCHES POND LN STE 101
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6294
Practice Address - Country:US
Practice Address - Phone:919-467-7425
Practice Address - Fax:919-467-7412
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01454208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics