Provider Demographics
NPI:1588829220
Name:BHATIA, VIPUL (MD)
Entity Type:Individual
Prefix:DR
First Name:VIPUL
Middle Name:
Last Name:BHATIA
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 1:3421 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:717-717-8003
Mailing Address - Fax:717-461-7404
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:2008-07-22
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443504207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA417206OtherUPMC
PA30101154OtherAMERIHEALTH MERCY-WMG
PA1600004OtherGATEWAY
PA30131985OtherAMERIHEALTH MERCY - WMG
PA102618799Medicaid
MD044473100Medicaid
PA2642520OtherHIGHMARK BLUE SHIELD
PA30131985OtherAMERIHEALTH MERCY - WMG
PA417206OtherUPMC
PA2642520OtherHIGHMARK BLUE SHIELD