Organization
L VIJAYA. MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE B BRENDLE (OFFICE MANAGER)
(252) 492-8711
Entity
Organization
Contact information
Practice address
568 RUIN CREEK RD, STE. 121, HENDERSON, NC 27536-2880
(252) 492-8711
(252) 492-2028
Mailing address
568 RUIN CREEK RD, SUITE 121, HENDERSON, NC 27536-2880
(252) 492-8711
(252) 492-2028
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19957
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8985084
—
NC
Enumeration date
05/25/2007
Last updated
09/22/2008
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