Provider Demographics
NPI:1043211493
Name:SALARIA, VIKRANT (MD)
Entity type:Individual
Prefix:DR
First Name:VIKRANT
Middle Name:
Last Name:SALARIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 N 16TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-0109
Mailing Address - Country:US
Mailing Address - Phone:712-256-8885
Mailing Address - Fax:712-568-8884
Practice Address - Street 1:1720 N 16TH ST STE F
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-0109
Practice Address - Country:US
Practice Address - Phone:712-256-8885
Practice Address - Fax:712-256-8884
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025251500Medicaid
IA5441030Medicaid
IA5441030Medicaid
NE10025251500Medicaid