Provider Demographics
NPI:1972774123
Name:ATTALURI, VIKRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:ATTALURI
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 1:12638 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-6203
Mailing Address - Country:US
Mailing Address - Phone:312-404-5070
Mailing Address - Fax:
Practice Address - Street 1:12638 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-6203
Practice Address - Country:US
Practice Address - Phone:312-404-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.011981208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery