Provider Demographics
NPI:1821126970
Name:VIPUL D BRAHMBHATT M.D.,PC
Entity Type:Organization
Organization Name:VIPUL D BRAHMBHATT M.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRAHMBHATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-288-6660
Mailing Address - Street 1:930 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3639
Mailing Address - Country:US
Mailing Address - Phone:812-288-6660
Mailing Address - Fax:812-283-5975
Practice Address - Street 1:930 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3639
Practice Address - Country:US
Practice Address - Phone:812-288-6660
Practice Address - Fax:812-283-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherFERERAL TAX ID