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General NPI Number Information
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NPI Number | 1780769224
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Entity Type | Organization
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Legal Business Name | VEIN & COSMETIC SOLUTIONS
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 7626 TIMBERLAKE RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-2325
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Country | US
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Telephone | 434-847-5347
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Fax | 434-316-7008
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Provider Business Mailing Address
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Address Line | 7626 TIMBERLAKE RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-2325
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Country | US
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Telephone | 434-847-5347
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Fax | 434-316-7008
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY H WIDMEYER
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Credential | MD
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Telephone | 434-847-5347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101049993
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License Number State | VA
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