Individual
DR. VIKRAM S BAJWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 529-0449
Mailing address
405 W JACKSON STREET, SIH MEDICAL GROUP ANESTHESIOLOGY, CARBONDALE, IL 62901
(618) 549-0721
(618) 529-0449
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036142998
IL
207R00000X
Internal Medicine Physician
57. 021556
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
GROUP PTAN
IL
Enumeration date
10/23/2012
Last updated
12/14/2023
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