Provider Demographics
NPI:1780874313
Name:PUNJABI, VIKAS (DO)
Entity type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:
Last Name:PUNJABI
Suffix:
Gender:M
Credentials:DO
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 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST STE 526
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-8127
Practice Address - Country:US
Practice Address - Phone:504-648-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILTEM-COV19-35650207RP1001X, 207RC0200X
CA20A12352207RP1001X, 207RC0200X, 207R00000X
GA78211207RC0200X
MT18093207R00000X, 207RC0200X
IL35650207RC0200X
LA312442207RC0200X
MI5101019620207RC0200X
IL036124486207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101019620OtherDEPT. OF LICENSING AND REGULATORY AFFAIRS
IL036124486OtherILLINOIS DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION
CA20A12352OtherOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA