Individual
SHIVA GOPAL VASISHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 EVESHAM ROAD, PAVILION 800 SUITE 209, VOORHEES, NJ 08043
(856) 651-0060
Mailing address
2301 EVESHAM ROAD, PAVILION 800 SUITE 209, VOORHEES, NJ 08043
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA55133
NJ
Other
Enumeration date
12/11/2006
Last updated
12/28/2007
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