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Individual

DR. VIKAS S. BAWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1060 BROAD ST, LOWER LEVEL MEDICAL OFFICE, NEWARK, NJ 07102-2397
(973) 642-6500
(973) 741-2700
Mailing address
12 SHERWOOD LN, COLUMBUS, NJ 08022-2248
(973) 906-3344

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00260200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8560005
NJ
Enumeration date
11/07/2006
Last updated
09/04/2008
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