Provider Demographics
NPI:1992390975
Name:VK IATROS PLLC
Entity Type:Organization
Organization Name:VK IATROS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAYAKIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-910-3884
Mailing Address - Street 1:24789 TODDY LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2075
Mailing Address - Country:US
Mailing Address - Phone:248-910-3884
Mailing Address - Fax:
Practice Address - Street 1:47601 GRAND RIVER AVE FL LABOR3
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1233
Practice Address - Country:US
Practice Address - Phone:248-910-3884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty