Provider Demographics
NPI:1275579708
Name:NAVANI, KAVITA MOTUMAL (MD)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:MOTUMAL
Last Name:NAVANI
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 1:201 HIGHLAND ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-1037
Mailing Address - Country:US
Mailing Address - Phone:978-365-8200
Mailing Address - Fax:978-368-1214
Practice Address - Street 1:201 HIGHLAND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-1037
Practice Address - Country:US
Practice Address - Phone:978-365-8200
Practice Address - Fax:978-368-1214
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9707701Medicaid
MA150431OtherTUFTS INSURANCE
MD999297OtherNETWORK HEALTH
MA150431OtherLICENSE
MAJ16804OtherBLUE CROSS
MA9707701Medicaid
A21617Medicare ID - Type Unspecified