Provider Demographics
NPI:1386649051
Name:DAVE, KAVITA P (DO)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:P
Last Name:DAVE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAVITA
Other - Middle Name:P
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:25 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2918
Mailing Address - Country:US
Mailing Address - Phone:717-730-9782
Mailing Address - Fax:
Practice Address - Street 1:25 N 32ND ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2918
Practice Address - Country:US
Practice Address - Phone:717-730-9782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAR667758OtherBCBS ID NUMBER
COAR667758OtherBCBS ID NUMBER
G88113Medicare UPIN