Provider Demographics
NPI:1659589323
Name:KARODY, VIJENDER RAO (MD)
Entity Type:Individual
Prefix:
First Name:VIJENDER
Middle Name:RAO
Last Name:KARODY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF NEONATOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-6820
Mailing Address - Fax:414-266-6979
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF NEONATOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-6820
Practice Address - Fax:414-266-6979
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH57009712208000000X
WI516592080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1659589323Medicaid
WI73601 2224Medicare PIN
WI68086 0991Medicare PIN