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NPI Code Detail

MEDICARE: NILAM RAKESH TRIVEDI OD

MEDICARE: NILAM RAKESH TRIVEDI OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist4901005249MI

General Provider Information

NPI Number : 1649838616
Entity Type Code : Individual
Provider Name (Legal Business Name) : NILAM RAKESH TRIVEDI OD
Provider Business Mailing Address
First Line : 29866 HEMLOCK AVE
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48336-2055
Country : US
Telephone Number : 248-996-2851
Fax Number :
Provider Business Practice Location Address
First Line : 35184 CENTRAL CITY PKWY
Second Line :
City : WESTLAND
State : MI
Zip : 48185-6215
Country : US
Telephone Number : 734-427-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 06/04/2019

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