Provider Demographics
NPI:1518912534
Name:TRIVEDI, BHAVINI (MD)
Entity Type:Individual
Prefix:
First Name:BHAVINI
Middle Name:
Last Name: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 1:6 PIDGEON HILL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6146
Mailing Address - Country:US
Mailing Address - Phone:703-444-7234
Mailing Address - Fax:703-444-7201
Practice Address - Street 1:6 PIDGEON HILL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6146
Practice Address - Country:US
Practice Address - Phone:703-444-7234
Practice Address - Fax:703-444-7201
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231070207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H72663Medicare UPIN