Provider Demographics
NPI:1548256936
Name:VIJAY, NAMPALLI K (MD)
Entity type:Individual
Prefix:DR
First Name:NAMPALLI
Middle Name:K
Last Name:VIJAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-839-7100
Mailing Address - Fax:303-839-7249
Practice Address - Street 1:1601 E 19TH AVE STE 5000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1254
Practice Address - Country:US
Practice Address - Phone:303-839-7100
Practice Address - Fax:303-839-7249
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO21147207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026280800Medicaid
KS100171280DMedicaid
NE10026280700Medicaid
NE10026281200Medicaid
NE10026281000Medicaid
NE1982948089Medicaid
CO01211473Medicaid
NE10026280600Medicaid
NE10026283100Medicaid
WY104587300Medicaid
NE1548256936Medicaid
NE10026280700Medicaid
NE10026281200Medicaid
KS100171280DMedicaid
NE10026280800Medicaid
NENA2301008Medicare PIN