Basic Information
| Provider Information | |||||||||
| NPI: | 1548780364 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AKKI VIVEKANAND | ||||||||
| FirstName: | VINUTHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD FL 3 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434445601 | ||||||||
| FaxNumber: | 4434445606 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD FL 3 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434445600 | ||||||||
| FaxNumber: | 4434445606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2017 | ||||||||
| LastUpdateDate: | 07/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0089283 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.