MEDICARE: DR. BRENDA P VIEGAS M.D.

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	208000000X	Pediatrics Physician	01026623A	IN

General Provider Information

NPI Number	:	1952357667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENDA P VIEGAS M.D.

Provider Business Mailing Address
First Line	:	360 S MADISON AVE
Second Line	:	# 210
City	:	GREENWOOD
State	:	IN
Zip	:	46142-3150
Country	:	US
Telephone Number	:	317-881-3232
Fax Number	:	317-881-3796

Provider Business Practice Location Address
First Line	:	360 S MADISON AVE
Second Line	:	# 210
City	:	GREENWOOD
State	:	IN
Zip	:	46142-3150
Country	:	US
Telephone Number	:	317-881-3232
Fax Number	:	317-881-3796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	02/08/2011

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