Healthcare Provider Details

I. General information

NPI: 1205997913
Provider Name (Legal Business Name): VERONICA ALFERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 E BROADWAY SUITE 621
EUGENE OR
97401-3143
US

IV. Provider business mailing address

132 E BROADWAY SUITE 621
EUGENE OR
97401-3143
US

V. Phone/Fax

Practice location:
  • Phone: 541-344-7637
  • Fax: 541-344-7884
Mailing address:
  • Phone: 541-344-7637
  • Fax: 541-344-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD15889
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier062158
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: