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Organization
PRAKASH K VIN MD PC
Active
Organization
PRAKASH K VIN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAKASH K VIN MD (PRESIDENT)
(724) 694-2765
Entity
Organization
Contact information
Practice address
118 W FOURTH AVE, DERRY, PA 15627
(724) 694-2765
(724) 694-2870
Mailing address
PO BOX 215, DERRY, PA 15627
(724) 694-2765
(724) 694-2870
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD037361L
PA
207RG0100X
Gastroenterology Physician
MD037361L
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD037361L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000626144
—
PA
01
—
060480
UNISON
—
01
—
1016662
GATEWAY
—
01
—
112076401
UPMC FOR YOU
—
01
—
154859
HIGHMARK PRODUCTS
—
01
—
219922
HEALTH AMERICA HEALTH ASS
—
01
—
77498
USHC
—
01
—
VENDOR#0000004047
UPMC
—
Enumeration date
11/28/2006
Last updated
10/01/2013
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