Provider Demographics
NPI:1952888166
Name:VIKRAMAN, PRAVEEN KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:PRAVEEN KUMAR
Middle Name:
Last Name:VIKRAMAN
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 1:200 MEDICAL CENTER DR STE 2O
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9422
Mailing Address - Country:US
Mailing Address - Phone:606-439-8450
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL CENTER DR STE 2O
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9422
Practice Address - Country:US
Practice Address - Phone:606-439-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311237207RI0200X
KY57666207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease