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General NPI Number Information
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NPI Number | 1417298027
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Entity Type | Individual
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Provider Name | ELENA E VEGA DO
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Gender | Female
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Dates
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Enumeration Date | 03/06/2013
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 6060 PIEDMONT ROW DR S STE 450
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City | CHARLOTTE
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State | NC
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Zip | 28287-3884
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Country | US
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Telephone | 704-317-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 EASTBURN RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-4704
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Country | US
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Telephone | 559-341-9943
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MB09520400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 271967
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2020-00744
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License Number State | NC
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