MEDICARE: VEIN ASSOCIATES DURHAM, P.C.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1497784490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEIN ASSOCIATES DURHAM, P.C.

Provider Business Mailing Address
First Line	:	5015 SOUTHPARK DR
Second Line	:	STE 100
City	:	DURHAM
State	:	NC
Zip	:	27713-7736
Country	:	US
Telephone Number	:	919-405-4200
Fax Number	:	919-405-4210

Provider Business Practice Location Address
First Line	:	5015 SOUTHPARK DR
Second Line	:	STE 100
City	:	DURHAM
State	:	NC
Zip	:	27713-7736
Country	:	US
Telephone Number	:	919-405-4200
Fax Number	:	919-405-4210

Authorized Official
Title or Position	:	CREDENTIALING SPRCIALIST
Name	:	ANNE FOLEY
Credential	:
Telephone Number	:	919-405-4200

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	03/09/2008

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