Individual
VIJAY SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
97784
GA
208000000X
Pediatrics Physician
MD073756L
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
97784
GA
2080P0203X
Pediatric Critical Care Medicine Physician
MD073756L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089852EMD
MEDICARE PTAN
PA
05
—
1012277730
—
PA
Enumeration date
08/22/2006
Last updated
03/25/2025
Update your record
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