Individual
KEVIN VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(215) 707-2000
Mailing address
2201 BRYN MAWR AVE APT PH3-09, PHILADELPHIA, PA 19131-2102
(805) 407-6091
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT223859
PA
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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