Individual
DR. JUSTIN VADAPARAMPIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4453 CASTOR AVE, SUITE B, PHILADELPHIA, PA 19124-3846
(212) 523-5918
(215) 743-9247
Mailing address
4453 CASTOR AVE, SUITE B, PHILADELPHIA, PA 19124-3846
(215) 744-2266
(215) 743-9247
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD434573
PA
207R00000X
Internal Medicine Physician
MT187155
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0168564
—
NJ
05
—
1021914320001
—
PA
Enumeration date
05/19/2007
Last updated
04/16/2013
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