MEDICARE: THE VEIN DOCTOR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1487688438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VEIN DOCTOR, LLC

Provider Business Mailing Address
First Line	:	3651 PEACHTREE PKWY
Second Line	:	SUITE 386
City	:	SUWANEE
State	:	GA
Zip	:	30024-6034
Country	:	US
Telephone Number	:	678-528-7078
Fax Number	:

Provider Business Practice Location Address
First Line	:	4855 RIVER GREEN PKWY
Second Line	:	SUITE 140
City	:	DULUTH
State	:	GA
Zip	:	30096-8336
Country	:	US
Telephone Number	:	678-528-7078
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	SEAN E.F. DELANEY
Credential	:
Telephone Number	:	678-528-7078

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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Directions to “THE VEIN DOCTOR, LLC ” Practice Location

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