Individual
VIKRAM K BATHULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3500
(856) 365-4088
Mailing address
301 LIPPINCOTT DRIVE, SUITE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301083907
MI
207R00000X
Internal Medicine Physician
MD432895
PA
208M00000X
Hospitalist Physician
Primary
25MA08490700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
MEDICAID GROUP TPI
PA
01
—
597586
MEDICARE GROUP TPI
PA
01
—
CD4829
RAILROAD MEDICARE TPI GROUP
PA
Enumeration date
06/29/2007
Last updated
04/27/2021
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