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NPI Code Detail

MEDICARE: VIJIAN DHEVAN M.D.

MEDICARE: VIJIAN DHEVAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician125-052980IL
2208600000XSurgery PhysicianP3310TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2H08JE00001OTHERTXBCBS

General Provider Information

NPI Number : 1003015421
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIJIAN DHEVAN M.D.
Provider Business Mailing Address
First Line : PO BOX 5730
Second Line :
City : BELFAST
State : ME
Zip : 04915-5700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2222 VELA DR
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-8981
Country : US
Telephone Number : 956-804-5851
Fax Number : 956-271-0289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 01/24/2025

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