Provider Demographics
NPI:1811976525
Name:VICTOR, VIJAYALEELA G (MD)
Entity type:Individual
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First Name:VIJAYALEELA
Middle Name:G
Last Name:VICTOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:350 ASHTON DR
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-4813
Mailing Address - Country:US
Mailing Address - Phone:304-274-2345
Mailing Address - Fax:
Practice Address - Street 1:510 BUTLER AVE
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-9990
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:304-262-4898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY177646207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology