Provider Demographics
NPI:1114943388
Name:VEVERA, ELIZABETH C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:C
Last Name:VEVERA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1505 NORTHSIDE BLVD
Mailing Address - Street 2:STE 4400
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7623
Mailing Address - Country:US
Mailing Address - Phone:678-513-8800
Mailing Address - Fax:678-513-8500
Practice Address - Street 1:1505 NORTHSIDE BLVD
Practice Address - Street 2:STE 4400
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7623
Practice Address - Country:US
Practice Address - Phone:678-513-8800
Practice Address - Fax:678-513-8500
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-10-15
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Provider Licenses
StateLicense IDTaxonomies
GA041990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003149913AMedicaid
GA003149913AMedicaid
GA202I081900Medicare PIN