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Individual

VIPULKUMAR R BRAHMBHATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
310 N STATE OF FRANKLIN RD STE 400, JOHNSON CITY, TN 37604-6051
(423) 979-6000
(423) 979-6011
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
039886
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
51930
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007697614
AETNA
05
100134513
WI
05
1679559165
VA
05
3333835
TN
01
4232015
BLUE CROSS BLUE SHIELD
TN
05
5912618
NC
05
64112550
KY
01
7696872
CIGNA
Enumeration date
12/16/2005
Last updated
10/10/2023
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