Individual
DR. VIPUL MAHAJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-5545
(541) 732-5548
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-5545
(541) 732-5548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD177085
OR
208M00000X
Hospitalist Physician
Primary
MD177085
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500710574
—
OR
Enumeration date
04/03/2013
Last updated
03/22/2021
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