Provider Demographics
NPI:1871790741
Name:VIKRAM, BHADRASAIN (MD)
Entity type:Individual
Prefix:DR
First Name:BHADRASAIN
Middle Name:
Last Name:VIKRAM
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 1:17050 CATALPA CT
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2576
Mailing Address - Country:US
Mailing Address - Phone:301-496-6111
Mailing Address - Fax:
Practice Address - Street 1:17050 CATALPA CT
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2576
Practice Address - Country:US
Practice Address - Phone:301-496-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1359092085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology