# VIPUL DUA, MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033548029
- **Authorized official:** VIPUL DUA MD (OWNER)
- **Authorized official phone:** (860) 644-5900

## Contact information

- **Practice address:** 2800 TAMARACK AVE, SUITE 106, SOUTH WINDSOR, CT 06074-5539
- **Practice address phone:** (860) 644-5900
- **Practice address fax:** (860) 644-5978
- **Mailing address:** 2800 TAMARACK AVE, SUITE 106, SOUTH WINDSOR, CT 06074-5539
- **Mailing address phone:** (860) 644-5900
- **Mailing address fax:** (860) 644-5978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 041795 | CT | Yes |

## Other

- **Enumeration date:** 11/11/2013
- **Last updated:** 11/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1730103862 | — | CT |