Physician Compare National (NPI:1730264011)

HEALTHCARE PROVIDER: MAURICE MICHAEL TRIVETTE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1730264011
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618148008
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110914000856
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TRIVETTE
	Individual professional last name
Provider First Name	MAURICE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9783 META HWY
	Group Practice or individual's line 1 address
City	PIKEVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	415014747
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6066310057
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIKEVILLE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y