Provider Demographics
NPI:1427020692
Name:VIJAYAKUMAR, RADHA D (MD)
Entity Type:Individual
Prefix:
First Name:RADHA
Middle Name:D
Last Name:VIJAYAKUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:736 CAMBRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2997
Mailing Address - Country:US
Mailing Address - Phone:617-789-3023
Mailing Address - Fax:617-789-2467
Practice Address - Street 1:5 BALLARD TER
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3201
Practice Address - Country:US
Practice Address - Phone:781-862-1607
Practice Address - Fax:781-862-1607
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2013-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA208879208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation