Individual
NIRANJAN VIJAYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S
Contact information
Practice address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
291526
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-47752
STATE LICENSE
KS
01
—
2023015773
STATE LICENSE
MO
Enumeration date
07/16/2015
Last updated
07/12/2023
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