Healthcare Provider Details

I. General information

NPI: 1295740033
Provider Name (Legal Business Name): VINOD KRIPALU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 FOULK RD SUITE 200B
WILMINGTON DE
19803-3820
US

IV. Provider business mailing address

410 FOULK RD SUITE 200B
WILMINGTON DE
19803-3820
US

V. Phone/Fax

Practice location:
  • Phone: 302-762-6675
  • Fax: 302-762-6695
Mailing address:
  • Phone: 302-762-6675
  • Fax: 302-762-6695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1000511
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: