Provider Demographics
NPI:1144765074
Name:PATEL, VIMA M (MD)
Entity type:Individual
Prefix:
First Name:VIMA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD STE M3
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2060
Mailing Address - Country:US
Mailing Address - Phone:856-262-9200
Mailing Address - Fax:215-521-7036
Practice Address - Street 1:188 FRIES MILL RD STE M3
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2060
Practice Address - Country:US
Practice Address - Phone:856-262-9200
Practice Address - Fax:215-521-7036
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12399800207RA0201X
PAMD473735207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology