Healthcare Provider Details

I. General information

NPI: 1366243172
Provider Name (Legal Business Name): VEIN AND WELLNESS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 IDLEWILD AVE STE 101
EASTON MD
21601-4049
US

IV. Provider business mailing address

166 DEFENSE HWY STE 101
ANNAPOLIS MD
21401-8921
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-3390
  • Fax: 410-224-3370
Mailing address:
  • Phone: 410-224-3390
  • Fax: 410-224-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LAUGHLIN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 443-370-5161