Provider Demographics
NPI:1386849826
Name:TRIVEDI, KAVITA (DO)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 E ONTARIO ST
Mailing Address - Street 2:APT #2201B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4808
Mailing Address - Country:US
Mailing Address - Phone:214-632-9353
Mailing Address - Fax:
Practice Address - Street 1:1500 E. MEDICAL CENTER DRIVE
Practice Address - Street 2:C213 MED INN BUILDING, BOX 0824
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-0824
Practice Address - Country:US
Practice Address - Phone:734-936-7922
Practice Address - Fax:734-936-6585
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010171322081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine