Organization
VASCULAR CENTER OF THE MIDWEST (VCM), LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANKAR M SUNDARAM (PRESIDENT)
(858) 829-4072
Entity
Organization
Contact information
Practice address
3085 WOODMAN DR STE 320, DAYTON, OH 45420-1171
(937) 795-1090
(937) 795-1145
Mailing address
78 PARK RD, OAKWOOD, OH 45419-3001
(858) 829-4072
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H868720
MEDICARE PTAN
OH
Enumeration date
03/10/2021
Last updated
11/08/2024
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