Provider Demographics
NPI:1447256342
Name:VORA, PRAFULLCHANDRA DOLATRAI (MD)
Entity type:Individual
Prefix:DR
First Name:PRAFULLCHANDRA
Middle Name:DOLATRAI
Last Name:VORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PRAFUL
Other - Middle Name:D
Other - Last Name:VORA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:249 ELM DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-8275
Mailing Address - Country:US
Mailing Address - Phone:724-627-8131
Mailing Address - Fax:
Practice Address - Street 1:249 ELM DRIVE
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370
Practice Address - Country:US
Practice Address - Phone:724-627-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023883E207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111346Medicare PIN
PAC30443Medicare UPIN