Provider Demographics
NPI:1346459856
Name:PATEL, VIPUL G (MD)
Entity Type:Individual
Prefix:
First Name:VIPUL
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4005
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432241207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD101973700Medicaid
PA1563899OtherGATEWAY-WMG
PA1976636OtherHIGHMARK BLUE SHIELD
PA20090411OtherAMERIHEALTH MERCY-WMG
PA217466OtherUNISON-WMG
PA211427OtherJOHNS HOPKINS
MD034080400Medicaid
PA30131832OtherAMERIHEALTH MERCY - WMG
PA110902OtherGEISINGER
2161248OtherMAMSI-WMG
MD900208OtherCAREFIRST MD BCBS
PA9119074OtherAETNA
PA114084EZ3Medicare PIN
PA20090411OtherAMERIHEALTH MERCY-WMG
PA30131832OtherAMERIHEALTH MERCY - WMG