Healthcare Provider Details

I. General information

NPI: 1386641397
Provider Name (Legal Business Name): CHARU L TRIVEDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 STEWART RD SUITE B
MONROE MI
48162-4226
US

IV. Provider business mailing address

3000 ARLINGTON AVE STOP 1108
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 734-242-7902
  • Fax:
Mailing address:
  • Phone: 419-383-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35078923T
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: