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General NPI Number Information
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NPI Number | 1457631590
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Entity Type | Individual
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Provider Name | SUSHMA KAVETI M.D
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Gender | Female
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Dates
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Enumeration Date | 08/21/2011
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD STE 5A43
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City | NEWARK
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State | DE
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Zip | 19718-1900
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Country | US
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Telephone | 302-623-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 501 S 54TH ST STE 382
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone |
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Fax |
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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 | MD449037
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C1-0012918
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License Number State | DE
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