Provider Demographics
NPI:1093731895
Name:PATEL, VIPIN S (MD)
Entity Type:Individual
Prefix:DR
First Name:VIPIN
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:40 VALLEY STREAM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1407
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:1010 LAKELAND SQUARE EXT STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7607
Practice Address - Country:US
Practice Address - Phone:601-936-0890
Practice Address - Fax:601-936-0891
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS097162085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05331232Medicaid