Provider Demographics
NPI:1346274891
Name:ARIVOLI, MEHALAI (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHALAI
Middle Name:
Last Name:ARIVOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEHALAI
Other - Middle Name:
Other - Last Name:THOLKAPPIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:390 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2062
Mailing Address - Country:US
Mailing Address - Phone:517-924-1465
Mailing Address - Fax:
Practice Address - Street 1:390 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2062
Practice Address - Country:US
Practice Address - Phone:517-924-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077145208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1230375OtherPHP/IBA
MI3501201012OtherBCBS PIN
MI4558211Medicaid