Healthcare Provider Details

I. General information

NPI: 1588309157
Provider Name (Legal Business Name): BEATRIZ VEGA FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEATRIZ VEGA MD

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DRIVE OLD CLINIC BUILDING 3020 CB # 7570
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

140 ALLEN RD
BASKING RIDGE NJ
07920-2976
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4150
  • Fax: 919-984-9952
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number25MA13098900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: