Provider Demographics
NPI:1487610929
Name:ARORA, VIJAY L (MD)
Entity type:Individual
Prefix:
First Name:VIJAY
Middle Name:L
Last Name:ARORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIJAY
Other - Middle Name:LAXMI
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4025 HIGHWAY 29 NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2819
Mailing Address - Country:US
Mailing Address - Phone:770-381-0307
Mailing Address - Fax:770-806-8117
Practice Address - Street 1:4025 HIGHWAY 29 NW
Practice Address - Street 2:SUITE B
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2819
Practice Address - Country:US
Practice Address - Phone:770-381-0307
Practice Address - Fax:770-806-8117
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA216332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA21633OtherSTATE LISCENCE