Basic Information
| Provider Information | |||||||||
| NPI: | 1558921791 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TRIVEN HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9039 ANTARES AVE STE E-2A | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432404067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8442814471 | ||||||||
| FaxNumber: | 6143568560 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 MCKINLEY PARK DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433026399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403838473 | ||||||||
| FaxNumber: | 7403838695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2019 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | BEKKAM | ||||||||
| AuthorizedOfficialFirstName: | NAVEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 8442814471 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.