Healthcare Provider Details

I. General information

NPI: 1013262690
Provider Name (Legal Business Name): VIPIN DAS VILLGRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 COVINGTON ST
YOUNGSTOWN OH
44510-1617
US

IV. Provider business mailing address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-3258
  • Fax:
Mailing address:
  • Phone: 412-359-3030
  • Fax: 412-359-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.144196
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT201895
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number50515
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30822
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0079468
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: