Provider Demographics
NPI:1508866997
Name:VEGA, HEATHER (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 EASY ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3129
Mailing Address - Country:US
Mailing Address - Phone:724-430-8755
Mailing Address - Fax:724-434-1659
Practice Address - Street 1:201 MARY HIGGINSON LN
Practice Address - Street 2:SUITE 201
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2658
Practice Address - Country:US
Practice Address - Phone:724-430-5940
Practice Address - Fax:724-430-3879
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010810L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA130704OtherMEDPLUS
PA1382633OtherHIGHMARK
PAP002579OtherGATEWAY
PA187471OtherHEALTH AMERICA
PA0015441410017Medicaid
PA310897OtherUPMC
PAP00069920OtherRAILROAD MEDICARE
PA130704OtherMEDPLUS
PA055263Medicare ID - Type Unspecified