Provider Demographics
NPI:1851520936
Name:VAZHAPPILLY, JOSJIN
Entity Type:Individual
Prefix:
First Name:JOSJIN
Middle Name:
Last Name:VAZHAPPILLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 TIDEWATER COLONY DR
Mailing Address - Street 2:SUITE 1 A
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2101
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-949-0825
Practice Address - Street 1:2007 TIDEWATER COLONY DR
Practice Address - Street 2:SUITE 1 A
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2101
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:443-949-0825
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071199207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine