Provider Demographics
NPI:1376430652
Name:MUJAWAR, VAHEEDA ILAI (MD)
Entity type:Individual
Prefix:DR
First Name:VAHEEDA
Middle Name:ILAI
Last Name:MUJAWAR
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 1:400 S GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-3776
Mailing Address - Country:US
Mailing Address - Phone:484-503-3073
Mailing Address - Fax:
Practice Address - Street 1:400 S GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-3776
Practice Address - Country:US
Practice Address - Phone:484-503-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT235513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine