Provider Demographics
NPI:1902109762
Name:GOYAL, KAVITA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:
Last Name:GOYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:145 HOSPITAL AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1462
Mailing Address - Country:US
Mailing Address - Phone:814-371-4361
Mailing Address - Fax:814-371-4360
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-371-4361
Practice Address - Fax:814-371-4360
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT196117207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine