Provider Demographics
NPI:1790839074
Name:DHRUVA, VIVEK N (DO)
Entity Type:Individual
Prefix:
First Name:VIVEK
Middle Name:N
Last Name:DHRUVA
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:443-643-3800
Mailing Address - Fax:443-643-3856
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-3800
Practice Address - Fax:443-643-3856
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH65450207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD141995ZCDKMedicare PIN