Provider Demographics
NPI:1033298047
Name:NIJJAR, VIKRAM SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:SINGH
Last Name:NIJJAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12484
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-2484
Mailing Address - Country:US
Mailing Address - Phone:318-448-1041
Mailing Address - Fax:318-448-0895
Practice Address - Street 1:2108 TEXAS AVE
Practice Address - Street 2:SUITE 2061
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3944
Practice Address - Country:US
Practice Address - Phone:318-448-1041
Practice Address - Fax:318-448-0895
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200908207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1507628Medicaid
AL00025987OtherSTATE MED LICENSE
LA4R018Medicare PIN