Provider Demographics
NPI:1578553913
Name:NETAJI, VINUTHA J (MD)
Entity Type:Individual
Prefix:DR
First Name:VINUTHA
Middle Name:J
Last Name:NETAJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4260
Mailing Address - Country:US
Mailing Address - Phone:610-279-1500
Mailing Address - Fax:
Practice Address - Street 1:342 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4260
Practice Address - Country:US
Practice Address - Phone:610-279-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01920689Medicaid
PAH73301Medicare UPIN