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General NPI Number Information
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NPI Number | 1821269929
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Entity Type | Organization
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Legal Business Name | RONALD A VIERK MD LLC
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 1900 CHESTER BLVD
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City | RICHMOND
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State | IN
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Zip | 47374-1213
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Country | US
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Telephone | 765-966-1945
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 HUNTERS POINTE DR
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City | RICHMOND
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State | IN
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Zip | 47374-7924
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Country | US
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Telephone | 765-966-1195
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD A VIERK
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Credential | M.D.
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Telephone | 765-966-1195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01031317B
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License Number State | IN
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