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General NPI Number Information
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NPI Number | 1437105921
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Entity Type | Individual
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Provider Name | VINITA SRIVASTAVA MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 401 GUESS ST STE. 100
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City | GREENVILLE
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State | SC
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Zip | 29605-4155
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Country | US
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Telephone | 864-233-2744
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Fax | 864-331-2896
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Provider Business Mailing Address
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Address Line | 401 GUESS ST STE. 100
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City | GREENVILLE
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State | SC
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Zip | 29605-4155
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Country | US
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Telephone | 864-233-2744
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Fax | 864-331-2896
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 18965
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 173F00000X
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Taxonomy Name | Sleep Specialist (PhD)
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License Number |
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License Number State | SC
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