Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | D21779 | MD |
NPI | 1063474260 |
---|---|
Provider Name | Vijay Kumar Nellore |
First Address | Bel Air, MD 21014-5410 |
Second Address | Perry Point, MD 21902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 26/10/2010 |