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Organization

VIPUL DUA, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIPUL DUA MD (OWNER)
(860) 644-5900
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
041795
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1730103862
CT
Enumeration date
11/11/2013
Last updated
11/11/2013
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