Provider Demographics
NPI:1396729190
Name:BARPUJARI, VIKRAM (MD)
Entity type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:BARPUJARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 E LAKE SHORE DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-3803
Mailing Address - Country:US
Mailing Address - Phone:217-464-1220
Mailing Address - Fax:217-464-1229
Practice Address - Street 1:1750 E LAKE SHORE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-3803
Practice Address - Country:US
Practice Address - Phone:217-464-1220
Practice Address - Fax:217-464-1229
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129480207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000348038OtherPA. BLUE SHIELD
PA0769653000OtherPERSONAL CHOICE
PA0000673779OtherBOEING BLUE SHIELD
PA0030907OtherAETNA US HEALTHCARE
PA0000161491OtherINDEPENDENCE BLUE CROSS
PA0769653000OtherAMERIHEALTH
PA00001981917 03OtherUNITED HEALTH CARE
PA0000348038OtherBLAIR MILL
PA0000673779OtherHORIZON BLUE SHIELD
PA0769653000OtherKEYSTONE HEALTH PLAN EAST
PA0769653000OtherKEYSTONE HEALTH PLAN EAST