Organization
VIKRAM R. SHUKLA, MD CHILD, ADOLESCENT & ADULT PSYCHIATRY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKRAM R SHUKLA MD (SOLE PROPRIETOR)
(704) 868-8988
Entity
Organization
Contact information
Practice address
839 MAJESTIC CT, SUITE 8, GASTONIA, NC 28054-5147
(704) 868-8988
(704) 868-9948
Mailing address
1100 VERDANT RIDGE CIR, BELMONT, NC 28012-7805
(704) 868-8988
(704) 868-9948
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33304
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11096051
CAQH ID
NC
01
—
2084P0804X
TAXONOMY
NC
01
—
33304
STATE LICENSE
NC
05
—
8976031
—
NC
Enumeration date
04/05/2016
Last updated
04/05/2016
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