Provider Demographics
NPI:1457318925
Name:SUKHATME, VIKAS P (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:P
Last Name:SUKHATME
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:RW 563
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-2105
Mailing Address - Fax:617-667-7581
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:RW 563
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2105
Practice Address - Fax:617-667-7581
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA76904207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA51153Medicare UPIN