Healthcare Provider Details

I. General information

NPI: 1841271269
Provider Name (Legal Business Name): VIKRAMJEET KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 E RIVER ST
ELYRIA OH
44035-5935
US

IV. Provider business mailing address

673 E RIVER ST
ELYRIA OH
44035-5935
US

V. Phone/Fax

Practice location:
  • Phone: 440-322-0872
  • Fax: 440-322-4991
Mailing address:
  • Phone: 440-322-0872
  • Fax: 440-322-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA11759300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35090011
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25MA11759300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: