Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4301091394 | MI |
NPI | 1033204615 |
---|---|
Provider Name | Vikram Govindaraju Shakkottai |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/09/2020 |