Individual
DR. SUDHIR BHARGAV VYAKARANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 PARK PL, MISHAWAKA, IN 46545-3519
(574) 273-6767
(574) 968-7160
Mailing address
PO BOX 5909, PORTLAND, OR 97228-5909
(574) 273-6767
(574) 968-7160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35095420
OH
207R00000X
Internal Medicine Physician
MT 187877
PA
207RN0300X
Nephrology Physician
Primary
01069102A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201018440
—
IN
Enumeration date
07/03/2008
Last updated
04/02/2020
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