Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD443424 | PA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD443424 | PA |
NPI | 1124355300 |
---|---|
Provider Name | Dr. Maheep Pratap Vikram |
First Address | Bethlehem, PA 18015-1000 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2009 |
Last Update Date | 15/08/2013 |