Provider Demographics
NPI:1598097420
Name:VMP MD PA
Entity Type:Organization
Organization Name:VMP MD PA
Other - Org Name:VIJAY PATEL FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:MANU
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-782-5288
Mailing Address - Street 1:1520 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2264
Mailing Address - Country:US
Mailing Address - Phone:919-782-5288
Mailing Address - Fax:919-782-5287
Practice Address - Street 1:1520 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-2264
Practice Address - Country:US
Practice Address - Phone:919-782-5288
Practice Address - Fax:919-782-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501373305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1033349261OtherDR. NGUYENS NPI
NC1992776140OtherDR PATELS NPI
NCG25499OtherUPIN
1306083639OtherELIZABETH ARRU, PA NPI
NC1710159454OtherNPI
10919701OtherCAQH NUMBER