Provider Demographics
NPI:1417134040
Name:WADHWA, VIKRAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:S
Last Name:WADHWA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:NEUROVASCULAR MEDICAL GROUP UCSF MEDICAL CENTER
Mailing Address - Street 2:505 PARNASSUS AVE, L352
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-353-1869
Mailing Address - Fax:415-353-8606
Practice Address - Street 1:NEUROVASCULAR MEDICAL GROUP UCSF MEDICAL CENTER
Practice Address - Street 2:505 PARNASSUS AVE, L352
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0001
Practice Address - Country:US
Practice Address - Phone:415-353-1869
Practice Address - Fax:415-353-8606
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1026052085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology