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General NPI Number Information
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NPI Number | 1194303891
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Entity Type | Individual
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Provider Name | VIKAS NAVA KODALI MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2006 HOGBACK RD STE 1
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City | ANN ARBOR
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State | MI
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Zip | 48105-9750
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Country | US
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Telephone | 734-786-2300
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Fax | 734-786-4915
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Provider Business Mailing Address
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Address Line | PO BOX 24449
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City | NEW YORK
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State | NY
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Zip | 10087-0589
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Country | US
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Telephone | 833-351-8255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A201674
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301514528
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0074577
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 334091
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License Number State | NY
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