Provider Demographics
NPI:1871584151
Name:PAUL, BIKRAM K (MD)
Entity type:Individual
Prefix:
First Name:BIKRAM
Middle Name:K
Last Name:PAUL
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 1:4646 LIVINGSTON RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3136
Mailing Address - Country:US
Mailing Address - Phone:202-349-9646
Mailing Address - Fax:202-217-4462
Practice Address - Street 1:4646 LIVINGSTON RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3136
Practice Address - Country:US
Practice Address - Phone:202-349-9646
Practice Address - Fax:202-217-4462
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD11475208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
149623Medicare ID - Type Unspecified
C87943Medicare UPIN