Individual
ELAMANA VIJAYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 LIBBEY INDUSTRIAL PKWY, SUITE 301, WEYMOUTH, MA 02189-3137
(781) 337-4224
(781) 335-0429
Mailing address
163 LIBBEY INDUSTRIAL PKWY, SUITE 301, WEYMOUTH, MA 02189-3137
(781) 337-4224
(781) 335-0429
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
81643
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
81643
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050083091
PALMETTO GBA
MA
01
—
081643
TUFTS HEALTH PLAN
MA
01
—
275023
HARVARD PILGRIM
MA
01
—
3145093
TRICARE
MA
05
—
3145093
—
MA
01
—
40044
FALLON
MA
01
—
J31645
BLUE SHIELD
MA
Enumeration date
07/19/2006
Last updated
06/10/2008
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