Provider Demographics
NPI:1194841478
Name:VEIN INNOVATIONS
Entity Type:Organization
Organization Name:VEIN INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN CRNFA
Authorized Official - Phone:678-731-9815
Mailing Address - Street 1:1140 HAMMOND DR
Mailing Address - Street 2:SUITE I 9150
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5338
Mailing Address - Country:US
Mailing Address - Phone:678-731-9815
Mailing Address - Fax:404-974-2968
Practice Address - Street 1:1140 HAMMOND DR
Practice Address - Street 2:SUITE I 9150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5334
Practice Address - Country:US
Practice Address - Phone:678-731-9815
Practice Address - Fax:404-974-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty