Individual
LUIS VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 FRANKLIN ST, COLON, MI 49040
(269) 432-3221
(269) 432-3120
Mailing address
121 E FRANKLIN ST, COLON, MI 49040-9363
(269) 432-3221
(269) 432-3120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LV080959
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-31372
PHYSICIANS HEALTH PLAN
MI
01
—
0807510341
BLUE CROSS BLUE SHIELD
MI
01
—
155177
GREAT LAKES HEALTH PLAN
MI
01
—
21611
HEALTH PLAN OF MICHIGAN
MI
05
—
4782700
—
MI
Enumeration date
07/16/2006
Last updated
03/18/2008
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