MEDICARE: VASUDEV MUKUNDRAI VIRPARIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207RI0011X	Interventional Cardiology Physician	MD468748	PA
3	207RI0011X	Interventional Cardiology Physician	2018-01098	NC

General Provider Information

NPI Number	:	1043506884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VASUDEV MUKUNDRAI VIRPARIA M.D.

Provider Business Mailing Address
First Line	:	2160 STATE RD STE 1700
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-1812
Country	:	US
Telephone Number	:	223-287-8155
Fax Number	:	717-312-3153

Provider Business Practice Location Address
First Line	:	2160 STATE RD STE 1700
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-1812
Country	:	US
Telephone Number	:	223-287-8155
Fax Number	:	717-312-3153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2011
Last Update Date	:	11/16/2022

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