Provider Demographics
NPI:1043451727
Name:TRIVEDI, BHARGAV A (MD)
Entity type:Individual
Prefix:
First Name:BHARGAV
Middle Name:A
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3407
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47733-3407
Mailing Address - Country:US
Mailing Address - Phone:812-450-7338
Mailing Address - Fax:812-450-2193
Practice Address - Street 1:600 MARY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1674
Practice Address - Country:US
Practice Address - Phone:812-450-7338
Practice Address - Fax:812-450-2193
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01077009A2084N0400X
IL0361240032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036124003Medicaid
IN201367960Medicaid
IN201367960Medicaid
IL036124003Medicaid
IL214881Medicare Oscar/Certification