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Individual

JOSE ANTONIO VEGA PERALTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15700 37TH AVE N STE 300, PLYMOUTH, MN 55446-3661
(612) 624-5915
(612) 624-1473
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1114
(612) 870-5491

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
55180
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18660
INTERNAL MEDICINE RESIDENT PERMIT NUMBER
MN
Enumeration date
05/08/2008
Last updated
02/16/2018
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