Provider Demographics
NPI:1114614377
Name:BYROJU, VISHNU VARDHAN (MD)
Entity Type:Individual
Prefix:
First Name:VISHNU
Middle Name:VARDHAN
Last Name:BYROJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COOPER UNIVERSITY HEALTHCARE
Mailing Address - Street 2:1 COOPER PLAZA
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103
Mailing Address - Country:US
Mailing Address - Phone:856-342-2000
Mailing Address - Fax:856-757-7803
Practice Address - Street 1:COOPER UNIVERSITY HEALTHCARE
Practice Address - Street 2:1 COOPER PLAZA
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2000
Practice Address - Fax:856-757-7803
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program