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Individual

DR. NIMISHA J TRIVEDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3778 HIGHWAY 42, LOCUST GROVE, GA 30248
(678) 610-6649
(678) 610-6025
Mailing address
3778 HIGHWAY 42, LOCUST GROVE, GA 30248
(678) 610-6649
(678) 610-6025

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053715
GA
261QU0200X
Urgent Care Clinic/Center
053715
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117518856A
GA
Enumeration date
06/28/2005
Last updated
09/15/2016
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