Healthcare Provider Details

I. General information

NPI: 1295114395
Provider Name (Legal Business Name): KAVITA PANDIT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U WASHINGTON DEPT OF SURGERY 1959 NE PACIFIC ST BOX 356410
SEATTLE WA
98195-6410
US

IV. Provider business mailing address

U WASHINGTON DEPT OF SURGERY 1959 NE PACIFIC ST BOX 356410
SEATTLE WA
98195-6410
US

V. Phone/Fax

Practice location:
  • Phone: 609-744-5126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD60767677
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: