Healthcare Provider Details

I. General information

NPI: 1043258403
Provider Name (Legal Business Name): KAWITA VICHARE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 DELAFIELD RD BLDG 51
PITTSBURGH PA
15215-1802
US

IV. Provider business mailing address

1010 DELAFIELD RD BLDG 70
PITTSBURGH PA
15215-1802
US

V. Phone/Fax

Practice location:
  • Phone: 124-822-1664
  • Fax:
Mailing address:
  • Phone: 412-822-1664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD424785
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD424785
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: