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Individual

DR. VIJAY KUMAR REKHALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1705 WARREN AVE, SUITE 209, WILLIAMSPORT, PA 17701-2647
(570) 326-1283
Mailing address
1774 MCCONNELL DR, WILLIAMSPORT, PA 17701-9300
(570) 326-1283
(570) 326-0391

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD029239E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009159600001
PA
01
432264
BLUE SHIELD
PA
Enumeration date
07/26/2006
Last updated
01/05/2017
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