Provider Demographics
NPI:1174518880
Name:VALLABH, VINOD CHITA (MD, FRCP)
Entity type:Individual
Prefix:DR
First Name:VINOD
Middle Name:CHITA
Last Name:VALLABH
Suffix:
Gender:M
Credentials:MD, FRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2016
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27512-2016
Mailing Address - Country:US
Mailing Address - Phone:919-854-2500
Mailing Address - Fax:919-854-2510
Practice Address - Street 1:570 NEW WAVERLY PL
Practice Address - Street 2:#140
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7405
Practice Address - Country:US
Practice Address - Phone:919-854-2500
Practice Address - Fax:919-854-2510
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31084207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7985119Medicaid
NC7985119Medicaid
NC211121GMedicare PIN