Provider Demographics
NPI:1003022120
Name:VIEIRA, MAUREEN (NP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:VIEIRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4447
Mailing Address - Country:US
Mailing Address - Phone:209-577-5005
Mailing Address - Fax:209-521-1533
Practice Address - Street 1:200 W COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4447
Practice Address - Country:US
Practice Address - Phone:209-577-5005
Practice Address - Fax:209-521-1533
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE25237207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology