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NPI Code Detail

MEDICARE: DR. ASHWINI BHARADWAJ VIJAYAKUMAR MD

MEDICARE: DR. ASHWINI BHARADWAJ VIJAYAKUMAR MD
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 PhysicianPT24430ND

General Provider Information

NPI Number : 1487140042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHWINI BHARADWAJ VIJAYAKUMAR MD
Provider Business Mailing Address
First Line : 1301 15TH AVE W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-3821
Country : US
Telephone Number : 701-774-7401
Fax Number :
Provider Business Practice Location Address
First Line : 1301 15TH AVE W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-3821
Country : US
Telephone Number : 701-774-7401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2018
Last Update Date : 06/01/2026

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