Provider Demographics
NPI:1225714140
Name:VEGGAL, MANISHEA KAUR (MD)
Entity Type:Individual
Prefix:
First Name:MANISHEA
Middle Name:KAUR
Last Name:VEGGAL
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:GRAND STRAND MEDICAL CENTER-GME OFFICE
Mailing Address - Street 2:809 82ND PARKWAY
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572
Mailing Address - Country:US
Mailing Address - Phone:843-692-3497
Mailing Address - Fax:843-692-1122
Practice Address - Street 1:GRAND STRAND MEDICAL CENTER
Practice Address - Street 2:809 82ND PARKWAY
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572
Practice Address - Country:US
Practice Address - Phone:843-848-4640
Practice Address - Fax:843-236-1500
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program