Provider Demographics
NPI:1447231758
Name:VEKARIA, KISHOR S (MD)
Entity Type:Individual
Prefix:
First Name:KISHOR
Middle Name:S
Last Name:VEKARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KISHOR KUMAR
Other - Middle Name:S
Other - Last Name:VEKARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2369
Practice Address - Country:US
Practice Address - Phone:570-703-8284
Practice Address - Fax:570-703-7250
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034381E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012231630006Medicaid
PA050034575OtherRR MEDICARE
PAVE586756OtherMEDICARE
PA0012231630006Medicaid
E32478Medicare UPIN