Basic Information
Provider Information
NPI: 1174727564
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JANAKIRAM VITHESWARAN
FirstName: AKSHAI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: JANAK
OtherFirstName: AKSHAI
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 101 SIVLEY RD SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014421
CountryCode: US
TelephoneNumber: 2562651000
FaxNumber:  
Practice Location
Address1: 201 SIVLEY RD SW
Address2: STE.500
City: HUNTSVILLE
State: AL
PostalCode: 358015134
CountryCode: US
TelephoneNumber: 2565198362
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/12/2007
LastUpdateDate: 01/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207QG0300X29832ALN Allopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
207QH0002X29832ALN Allopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
208M00000X29832ALY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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