Individual
VIJI SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2149 VALLEYGATE DR STE 201, FAYETTEVILLE, NC 28304-3668
(910) 687-4888
Mailing address
695 S BENNETT ST, SOUTHERN PINES, NC 28387-5919
(910) 687-4888
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MD437333
PA
208VP0014X
Interventional Pain Medicine Physician
Primary
2019-02792
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024620430001
—
PA
Enumeration date
09/18/2007
Last updated
04/28/2026
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