Provider Demographics
NPI:1730143157
Name:VERA, LUIS F (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:VERA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4320 SEMINARY RD
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1535
Mailing Address - Country:US
Mailing Address - Phone:703-504-3069
Mailing Address - Fax:703-504-3632
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:SUITE 3000
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3069
Practice Address - Fax:703-504-3632
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
VA01010284922080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6749119Medicaid
VAF10943Medicare UPIN