Provider Demographics
NPI:1720281785
Name:GILL, VIKRAMJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:VIKRAMJIT
Middle Name:SINGH
Last Name:GILL
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:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-258-3900
Mailing Address - Fax:513-636-7967
Practice Address - Street 1:3927 RUCKER AVE BLDG WIC
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4833
Practice Address - Country:US
Practice Address - Phone:425-339-5441
Practice Address - Fax:425-259-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3980207P00000X
IN01092842A207P00000X, 208000000X
OH35.099340207P00000X, 208000000X
WAMD61404786207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201159180Medicaid
WI100270020Medicaid