Healthcare Provider Details
I. General information
NPI: 1043998107
Provider Name (Legal Business Name): VEIGA MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1930 E THOMAS RD
PHOENIX AZ
85016-7711
US
IV. Provider business mailing address
PO BOX 25001
PHOENIX AZ
85002-5001
US
V. Phone/Fax
- Phone: 602-532-1000
- Fax:
- Phone: 925-817-8564
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KENNETH
VEIGA
Title or Position: PHYSICIAN
Credential: DO
Phone: 925-817-8564