Individual
VERGEL S ATIENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
390 S MAIN ST, SUITE 201, ROCKY MOUNT, VA 24151-1711
(540) 484-4800
(540) 484-4862
Mailing address
95 OXFORD CIR, ROCKY MOUNT, VA 24151-2134
(540) 483-7659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-050995
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005618703
—
VA
05
—
005621453
—
VA
01
—
453496
ANTHEM
VA
Enumeration date
12/05/2005
Last updated
08/11/2011
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