Provider Demographics
NPI:1043609886
Name:TRIVEDI, VIJAY
Entity type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ROGERS ROAD
Mailing Address - Street 2:
Mailing Address - City:REGINA
Mailing Address - State:SK
Mailing Address - Zip Code:S4S7C5
Mailing Address - Country:CA
Mailing Address - Phone:306-584-3326
Mailing Address - Fax:306-766-4134
Practice Address - Street 1:NUCLEAR MEDICINE REGINA GEN HOSP1440 14THE AVE
Practice Address - Street 2:
Practice Address - City:REGINA
Practice Address - State:SK
Practice Address - Zip Code:S4S7C5
Practice Address - Country:CA
Practice Address - Phone:306-766-4156
Practice Address - Fax:306-766-4134
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15952207UN0901X, 207UN0903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology