Individual
VIDULA T VACHHARAJANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157
(336) 716-2255
(336) 716-8190
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8190
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
2006-00910
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1422Y
BCBS
—
01
—
190420
MEDCOST
—
01
—
2062996
MEDICARE
NC
05
—
3810008365
—
WV
05
—
5906316
—
NC
01
—
7656568
AETNA
—
01
—
808022
PARTNERS
—
01
—
P00387756
RR MEDICARE
—
Enumeration date
07/24/2006
Last updated
09/16/2010
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