Individual
VIKRAM SAI SHIVAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4305
Mailing address
WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL BLVD, WINSTON SALEM, NC 27157-0001
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
2021-00646
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2016
Last updated
06/09/2021
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