Provider Demographics
NPI:1821276015
Name:ATTHOTA, VAKULA DEVI (MD,)
Entity Type:Individual
Prefix:DR
First Name:VAKULA
Middle Name:DEVI
Last Name:ATTHOTA
Suffix:
Gender:F
Credentials:MD,
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1450 E CHESTNUT AVE
Mailing Address - Street 2:BLDG 3 SUITE A
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-8467
Mailing Address - Country:US
Mailing Address - Phone:856-794-8700
Mailing Address - Fax:856-794-2752
Practice Address - Street 1:1450 E CHESTNUT AVE
Practice Address - Street 2:BLDG 3 SUITE A
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8467
Practice Address - Country:US
Practice Address - Phone:856-794-8700
Practice Address - Fax:856-794-2752
Is Sole Proprietor?:No
Enumeration Date:2008-02-10
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08958800207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0279862Medicaid
NJ224357CPCMedicare PIN