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General NPI Number Information
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NPI Number | 1649381518
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Entity Type | Individual
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Provider Name | MARK EDWARD VETH OD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 7511 HARWOOD AVE
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City | WAUWATOSA
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State | WI
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Zip | 53213-2606
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Country | US
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Telephone | 414-453-1300
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Fax | 414-453-1330
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Provider Business Mailing Address
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Address Line | 1155 KAVANAUGH
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City | WAUWATOSA
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State | WI
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Zip | 53213-3146
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Country | US
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Telephone | 414-520-8687
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Fax | 414-453-1330
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2956035
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2956-35
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License Number State | WI
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