Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 008852 | AZ |
Y | 111NI0900X | Internist | 008852 | AZ |
NPI | 1003303900 |
---|---|
Provider Name | Dr. Kenneth Veiga |
First Address | Phoenix, AZ 85008-4973 |
Second Address | Glendale, AZ 85306-4622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2018 |
Last Update Date | 12/08/2021 |