Provider Demographics
NPI:1821059544
Name:KALVA, GIRISH (MD)
Entity Type:Individual
Prefix:
First Name:GIRISH
Middle Name:
Last Name:KALVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5058 SOUTH, MORAY CT
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-3200
Mailing Address - Country:US
Mailing Address - Phone:801-913-7590
Mailing Address - Fax:801-272-6109
Practice Address - Street 1:5058 SOUTH, MORAY CT
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-3200
Practice Address - Country:US
Practice Address - Phone:801-913-7590
Practice Address - Fax:801-272-6109
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5637572-1205208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000060551Medicare PIN
I09115Medicare UPIN