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Individual
DR. VIDHYALAKSHMI KANNAN
Active
Individual
DR. VIDHYALAKSHMI KANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP1-0029419
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
46525
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46525
AZ STATE MEDICAL LICENSE BOARD
AZ
01
—
4663378067
MYUTMB 4663378067
—
Enumeration date
08/05/2007
Last updated
02/06/2015
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