Provider Demographics
NPI:1649582412
Name:KALIKI, VASAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:VASAVI
Middle Name:
Last Name:KALIKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 YORKMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6157
Mailing Address - Country:US
Mailing Address - Phone:804-762-9771
Mailing Address - Fax:
Practice Address - Street 1:4505 YORKMINSTER DR
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6157
Practice Address - Country:US
Practice Address - Phone:804-762-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438513207ZP0102X
NY254973207ZP0102X
VA0101250492207ZP0102X
CT50465207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400058432Medicare PIN