Individual
DR. GRACIE D VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1005 COMMERCIAL LN, SUITE 220, SUFFOLK, VA 23434-8149
(757) 668-2600
(757) 668-2620
Mailing address
1005 COMMERCIAL LN, SUITE 220, SUFFOLK, VA 23434-8149
(757) 668-2600
(757) 668-2620
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101056502
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891154T
—
NC
Enumeration date
03/31/2006
Last updated
11/30/2023
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