Provider Demographics
NPI:1508845009
Name:ZADOO, VIKRAM P (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:P
Last Name:ZADOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 CHADWICK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2623
Mailing Address - Country:US
Mailing Address - Phone:816-585-6899
Mailing Address - Fax:
Practice Address - Street 1:5404 CHADWICK RD
Practice Address - Street 2:
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205-2623
Practice Address - Country:US
Practice Address - Phone:816-585-6899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062008208200000X
MO2003015832208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208777904Medicaid
H37867Medicare UPIN
AL51534634Medicare Oscar/Certification