Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 25MB07842100 | NJ |
NPI | 1003078973 |
---|---|
Provider Name | Chirag D. Trivedi |
First Address | Phoenix, AZ 85014-5095 |
Second Address | Sun City, AZ 85351-2861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 17/02/2017 |