Basic Information
| Provider Information | |||||||||
| NPI: | 1639112865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SRIVASTAVA | ||||||||
| FirstName: | CHHAVI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4107 WATERFORD CIR | ||||||||
| Address2: | APT # 8 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402075302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028528156 | ||||||||
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| Practice Location | |||||||||
| Address1: | 530 S. JACKSON STREET | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028525851 | ||||||||
| FaxNumber: | 5028526056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | FL017 | KY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.