Provider Demographics
NPI:1023809910
Name:KATHROTIYA, HERIT DINESH
Entity type:Individual
Prefix:
First Name:HERIT
Middle Name:DINESH
Last Name:KATHROTIYA
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 1:119 KALLIE LOOP
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8070
Mailing Address - Country:US
Mailing Address - Phone:570-704-7989
Mailing Address - Fax:
Practice Address - Street 1:119 KALLIE LOOP
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8070
Practice Address - Country:US
Practice Address - Phone:570-704-7989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health