Healthcare Provider Details

I. General information

NPI: 1467893727
Provider Name (Legal Business Name): VIKAS SATYANANDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

22433 S VERMONT AVE APT 325
TORRANCE CA
90502-2427
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8454
  • Fax: 573-882-6054
Mailing address:
  • Phone: 412-297-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2024029051
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number2024029051
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: