Provider Demographics
NPI:1053607010
Name:VEGA, FRANCES MARIE (MD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:MARIE
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 OPITZ BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3373
Mailing Address - Country:US
Mailing Address - Phone:703-494-1144
Mailing Address - Fax:703-494-5647
Practice Address - Street 1:1924 OPITZ BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3373
Practice Address - Country:US
Practice Address - Phone:703-494-1144
Practice Address - Fax:703-494-5647
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072842208000000X
VA0101261237208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA072842OtherMD LICENSE
VA0101261237OtherMD LICENSE
VA0101261237OtherMD LICENSE