Individual
KAVITHA SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 E 17TH ST, CHEYENNE, WY 82001-4714
(307) 632-2434
(307) 634-3510
Mailing address
820 E 17TH ST, CHEYENNE, WY 82001-4714
(307) 632-2434
(307) 634-3510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
228-T2
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/06/2023
Last updated
07/26/2024
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