Healthcare Provider Details

I. General information

NPI: 1720356199
Provider Name (Legal Business Name): VEG ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2369 STAPLES MILL RD STE 100
RICHMOND VA
23230-2909
US

IV. Provider business mailing address

6094 14TH ST W STE 115
BRADENTON FL
34207-4104
US

V. Phone/Fax

Practice location:
  • Phone: 804-354-8818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: IRVIN J. SEEMAN
Title or Position: MEMBER
Credential: MD
Phone: 804-354-8818