Healthcare Provider Details

I. General information

NPI: 1073918199
Provider Name (Legal Business Name): DOUGLAS MCVEIGH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2014
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 JOHNS HOPKINS DR STE B
GREENVILLE NC
27834-7268
US

IV. Provider business mailing address

835 JOHNS HOPKINS DR STE B
GREENVILLE NC
27834-7268
US

V. Phone/Fax

Practice location:
  • Phone: 252-752-7422
  • Fax:
Mailing address:
  • Phone: 252-752-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberC51626
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: