Individual
KENNETH JOHN VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6849
(803) 434-8866
(803) 933-3049
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME82094
FL
207RG0100X
Gastroenterology Physician
079942
GA
207RG0100X
Gastroenterology Physician
27368
OK
207RG0100X
Gastroenterology Physician
56528
CO
207RG0100X
Gastroenterology Physician
Primary
93153
SC
207RG0100X
Gastroenterology Physician
ME82094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000114763
RAILROAD MEDICARE
FL
05
—
2604078-00
—
FL
Enumeration date
03/04/2006
Last updated
09/13/2024
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