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General NPI Number Information
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NPI Number | 1013166404
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Entity Type | Organization
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Legal Business Name | VIK POONAI M D PC
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 924 SETON DR
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City | CUMBERLAND
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State | MD
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Zip | 21502-1851
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Country | US
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Telephone | 301-777-5458
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Fax | 301-777-5459
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Provider Business Mailing Address
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Address Line | 924 SETON DR
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City | CUMBERLAND
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State | MD
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Zip | 21502-1851
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Country | US
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Telephone | 301-777-5458
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Fax | 301-777-5459
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIKRAMADI K POONAI
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Credential | M.D.
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Telephone | 301-777-5458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D36766
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License Number State | MD
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