Provider Demographics
NPI:1942295621
Name:KANNAN, VIJAY SHRI (MD)
Entity Type:Individual
Prefix:MS
First Name:VIJAY
Middle Name:SHRI
Last Name:KANNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10301 GEORGIA AVE
Mailing Address - Street 2:203
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5020
Mailing Address - Country:US
Mailing Address - Phone:301-681-7010
Mailing Address - Fax:301-593-8366
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:203
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-681-7010
Practice Address - Fax:301-593-8366
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2012-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0063183207P00000X
MDD63183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine