Individual
DR. LUIS R VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
300 MAPLE ST W, HAMPTON, SC 29924-3238
(803) 943-3813
(803) 943-5971
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23033
SC
208M00000X
Hospitalist Physician
23033
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230333
—
SC
01
—
GP5367
MEDICAID GROUP
SC
01
—
GP5421
GROUP MEDICAID
SC
01
—
P00846508
RR MEDICARE
SC
Enumeration date
07/22/2005
Last updated
06/08/2021
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