Provider Demographics
NPI:1457793150
Name:MULKANOOR, VINAY (DO)
Entity Type:Individual
Prefix:DR
First Name:VINAY
Middle Name:
Last Name:MULKANOOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:LEHIGH VALLEY HEALTH NETWORK, DEPT OF MEDICINE
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1556
Mailing Address - Country:US
Mailing Address - Phone:484-862-3170
Mailing Address - Fax:
Practice Address - Street 1:595 COPELAND MILL RD STE 2D
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-823-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013331207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology