Provider Demographics
NPI:1013948389
Name:TRIVEDI, DUSHYANT G (MD)
Entity Type:Individual
Prefix:
First Name:DUSHYANT
Middle Name:G
Last Name:TRIVEDI
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 1:555 WILLIAM ST., SUITE #24C
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2428
Mailing Address - Country:US
Mailing Address - Phone:734-994-1171
Mailing Address - Fax:734-712-5745
Practice Address - Street 1:555 WILLIAM ST., SUITE #24C
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2428
Practice Address - Country:US
Practice Address - Phone:734-994-1171
Practice Address - Fax:734-712-5745
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010349282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry