Provider Demographics
NPI:1295255305
Name:VIJAPURKAR, VISHAL MAHENDRA
Entity type:Individual
Prefix:
First Name:VISHAL
Middle Name:MAHENDRA
Last Name:VIJAPURKAR
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 1:6196 OXON HILL RD STE 450
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3173
Mailing Address - Country:US
Mailing Address - Phone:301-839-0400
Mailing Address - Fax:301-839-0130
Practice Address - Street 1:6196 OXON HILL RD STE 450
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745
Practice Address - Country:US
Practice Address - Phone:301-839-0400
Practice Address - Fax:301-839-0130
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26490225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist