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General NPI Number Information
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NPI Number | 1952981011
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Entity Type | Individual
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Provider Name | NIEL NIELSON VEIRUP IV DO
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Gender | Male
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW FL 1.5
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 202-476-3395
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Fax |
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Provider Business Mailing Address
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Address Line | 11034 HIAWATHA BLVD
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City | MOKENA
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State | IL
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Zip | 60448-1629
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Country | US
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Telephone | 708-653-8613
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | H0104314
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0102209247
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | DO210012556
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS20269
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License Number State | FL
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