Individual
DR. MICHELLE M VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 HADDON AVE, CAMDEN, NJ 08103
(856) 796-3500
(856) 365-7972
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA07788900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA07788900
NJ MEDICAL LICENSE
NJ
Enumeration date
03/08/2006
Last updated
03/07/2023
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