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Individual

PRITIKA SHRIVASTAVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3535 W 13 MILE RD STE 644, BEAUMONT MULTI-ORGAN TRANSPLANT CLINIC, ROYAL OAK, MI 48073-6770
(800) 253-5592
(248) 551-2125
Mailing address
130 TOWN CENTER DR STE 203, BEAUMONT PROVIDER ENROLLMENT, TROY, MI 48084-1744
(248) 585-8216

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301101565
MI
207R00000X
Internal Medicine Physician
MD434606
PA
207RN0300X
Nephrology Physician
Primary
4301101565
MI
207RN0300X
Nephrology Physician
MT190509
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102226350
PA
01
121910
GEISINGER HEALTH PLAN
PA
01
1577253
GATEWAY-WMG
PA
05
1811044878
MI
01
20080686
AMERIHEALTH MERCY-WMG
PA
01
2079421
HIGHMARK BLUE SHIELD
PA
01
226021
JOHNS HOPKINS
PA
01
257944
UNISON-WMG
PA
01
50081952
CAPITAL BLUE CROSS-WMG
PA
01
700F349850
BCBSM
MI
01
945883
CAREFIRST MD BCBS
MD
01
9815250
AETNA
PA
Enumeration date
05/29/2007
Last updated
06/23/2015
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