Healthcare Provider Details

I. General information

NPI: 1508845009
Provider Name (Legal Business Name): VIKRAM P ZADOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 CHADWICK RD
FAIRWAY KS
66205-2623
US

IV. Provider business mailing address

5404 CHADWICK RD
FAIRWAY KS
66205-2623
US

V. Phone/Fax

Practice location:
  • Phone: 816-585-6899
  • Fax:
Mailing address:
  • Phone: 816-585-6899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberDR.0062008
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2003015832
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: