Provider Demographics
NPI:1548780364
Name:AKKI VIVEKANAND, VINUTHA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:VINUTHA
Middle Name:
Last Name:AKKI VIVEKANAND
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 LOCH RAVEN BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2945
Mailing Address - Country:US
Mailing Address - Phone:443-444-5601
Mailing Address - Fax:443-444-5606
Practice Address - Street 1:5601 LOCH RAVEN BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2945
Practice Address - Country:US
Practice Address - Phone:443-444-5600
Practice Address - Fax:443-444-5606
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0089283207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine