Individual
BANGALORE S VIJAYALAKSHMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
9837
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13283
—
ND
01
—
137123
UCARE #
ND
01
—
2265220
AMERICA'S PPO/ARAZ #
ND
01
—
2300320
MEDICA #
ND
01
—
2300322
MEDICA #
ND
01
—
25030
NDBS #
ND
05
—
363627500
—
ND
01
—
38107
LHS #
ND
01
—
927S3VI
MNBS #
ND
01
—
DA9011042827
PREFERRED ONE #
ND
01
—
HP48628
HEALTHPARTNERS #
ND
Enumeration date
06/28/2006
Last updated
08/22/2011
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