Healthcare Provider Details

I. General information

NPI: 1346274891
Provider Name (Legal Business Name): MEHALAI ARIVOLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEHALAI THOLKAPPIAN

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 E CHICAGO ST
COLDWATER MI
49036-2062
US

IV. Provider business mailing address

390 E CHICAGO ST
COLDWATER MI
49036-2062
US

V. Phone/Fax

Practice location:
  • Phone: 517-924-1465
  • Fax:
Mailing address:
  • Phone: 517-924-1465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301077145
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: