Individual
VIJAYAKUMAR PRAVEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4351 E LOHMAN AVE, SUITE 100, LAS CRUCES, NM 88011-8259
(575) 532-9077
(575) 532-9221
Mailing address
4351 E LOHMAN AVE, SUITE 100, LAS CRUCES, NM 88011-8259
(575) 532-9077
(575) 532-9221
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
043312
CT
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD2009-0599
NM
Other
Enumeration date
06/30/2005
Last updated
05/23/2013
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