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NPI Code Detail

MEDICARE: VIKRAM BAMRA

MEDICARE:   VIKRAM  BAMRA
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
12085R0202XDiagnostic Radiology Physician60930 - 20WI

General Provider Information

NPI Number : 1952569667
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIKRAM BAMRA
Provider Business Mailing Address
First Line : 444 E CORCORAN AVE
Second Line : 601
City : MILWAUKEE
State : WI
Zip : 53202-6121
Country : US
Telephone Number : 510-590-1498
Fax Number :
Provider Business Practice Location Address
First Line : 4025 N 92ND ST
Second Line :
City : WAUWATOSA
State : WI
Zip : 53222-1613
Country : US
Telephone Number : 414-358-5437
Fax Number : 414-358-5421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2008
Last Update Date : 11/22/2021

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Directions to “ VIKRAM BAMRA ” Practice Location

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