Provider Demographics
NPI:1851374995
Name:LAKHANPAL, VINOD (MD)
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:
Last Name:LAKHANPAL
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 1:21 CROSSROADS DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5489
Mailing Address - Country:US
Mailing Address - Phone:410-581-2020
Mailing Address - Fax:410-581-8012
Practice Address - Street 1:21 CROSSROADS DR
Practice Address - Street 2:SUITE 425
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5441
Practice Address - Country:US
Practice Address - Phone:410-581-2020
Practice Address - Fax:410-581-8012
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD20190207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC57426Medicare UPIN
MDKL63HW67Medicare ID - Type Unspecified