Provider Demographics
NPI:1285735985
Name:KAVIT, MARK STEVEN
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEVEN
Last Name:KAVIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALTAMONT ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4615
Mailing Address - Country:US
Mailing Address - Phone:434-979-3353
Mailing Address - Fax:434-979-1358
Practice Address - Street 1:400 ALTAMONT ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4615
Practice Address - Country:US
Practice Address - Phone:434-979-3353
Practice Address - Fax:434-979-1358
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4454800001Medicare ID - Type Unspecified