Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 14956 | ND |
NPI | 1053559906 |
---|---|
Provider Name | Dr. Ashish Vijayakumar Regulagadda |
First Address | Fargo, ND 58122-2784 |
Second Address | Fargo, ND 58122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 18/07/2018 |