Healthcare Provider Details

I. General information

NPI: 1134415458
Provider Name (Legal Business Name): VIKRAM VAKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WADE AVE
CATONSVILLE MD
21228-4663
US

IV. Provider business mailing address

55 WADE AVE
CATONSVILLE MD
21228-4663
US

V. Phone/Fax

Practice location:
  • Phone: 614-226-7312
  • Fax:
Mailing address:
  • Phone: 614-226-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0090366
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: