MEDICARE: UZMA VAINCE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA07792500	NJ
2	208M00000X	Hospitalist Physician	D73271	MD

General Provider Information

NPI Number	:	1033179502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UZMA VAINCE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 427
Second Line	:
City	:	LEDERACH
State	:	PA
Zip	:	19450-0427
Country	:	US
Telephone Number	:	800-528-0006
Fax Number	:	732-349-6030

Provider Business Practice Location Address
First Line	:	5 GARRETT AVE
Second Line	:
City	:	LA PLATA
State	:	MD
Zip	:	20646-5960
Country	:	US
Telephone Number	:	301-609-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	06/05/2020

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