Healthcare Provider Details

I. General information

NPI: 1821019811
Provider Name (Legal Business Name): AMIT R TRIVEDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE HARBORVIEW MEDICAL CENTER
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE HARBORVIEW MEDICAL CENTER
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3074
  • Fax: 206-744-8546
Mailing address:
  • Phone: 206-744-3074
  • Fax: 206-744-8546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number200500322
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number200500322
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number60244738
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: