Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01071243A | IN |
N | 111NI0900X | Internist | 01071243A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 01071243A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 036141414 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01071243A | IN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 036.141414 | IL |
NPI | 1023270550 |
---|---|
Provider Name | Vikas Kalra |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 24/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
214881 | MEDICARE GROUP PTAN (01) | IL |