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Individual
VIJAYALAKSHMI L D VADREVU
Active
Individual
VIJAYALAKSHMI L D VADREVU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
75796-20
WI
207W00000X
Ophthalmology Physician
C52114
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165427
—
WI
01
—
75796-20
LICENSE
WI
Enumeration date
09/30/2006
Last updated
11/08/2021
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