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NPI Code Detail

MEDICARE: DR. BAL KRISHNA SRIVASTAVA MD

MEDICARE: DR. BAL KRISHNA SRIVASTAVA MD
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
1207RC0000XCardiovascular Disease Physician35072432OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000202320OTHEROHANTHEM

General Provider Information

NPI Number : 1871592345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BAL KRISHNA SRIVASTAVA MD
Provider Business Mailing Address
First Line : 61 DARST RD
Second Line :
City : DAYTON
State : OH
Zip : 45440-3407
Country : US
Telephone Number : 937-424-3589
Fax Number :
Provider Business Practice Location Address
First Line : 61 DARST RD
Second Line :
City : DAYTON
State : OH
Zip : 45440-3407
Country : US
Telephone Number : 937-424-3589
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 06/10/2025

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