Basic Information
| Provider Information | |||||||||
| NPI: | 1821200163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEVADE | ||||||||
| FirstName: | VIKAS | ||||||||
| MiddleName: | ANAND | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1632 SPRUCE ST APT 200 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191036734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322077777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 E LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | WYNNEWOOD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190963450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845651074 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2007 | ||||||||
| LastUpdateDate: | 10/12/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MD430920 | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 25MA08315900 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.