Provider Demographics
NPI:1609121615
Name:CAROLINA VEIN INSTITUTE
Entity Type:Organization
Organization Name:CAROLINA VEIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAQUERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-544-6318
Mailing Address - Street 1:100 EUROPA DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2357
Mailing Address - Country:US
Mailing Address - Phone:919-929-6777
Mailing Address - Fax:
Practice Address - Street 1:100 EUROPA DR
Practice Address - Street 2:SUITE 180
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2357
Practice Address - Country:US
Practice Address - Phone:919-929-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty