Healthcare Provider Details

I. General information

NPI: 1659376986
Provider Name (Legal Business Name): VIKRAM K CHAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 JEFFERSON ST SW SECOND FLOOR
ROANOKE VA
24014-2419
US

IV. Provider business mailing address

2013 JEFFERSON ST SW SECOND FLOOR
ROANOKE VA
24014-2419
US

V. Phone/Fax

Practice location:
  • Phone: 540-982-0237
  • Fax: 540-982-0103
Mailing address:
  • Phone: 540-982-0237
  • Fax: 540-982-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number36477
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: