Provider Demographics
NPI:1457337230
Name:VEYNA, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:VEYNA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:29275 NORTHWESTERN HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:877-784-3667
Mailing Address - Fax:248-869-3982
Practice Address - Street 1:43475 DALCOMA DR
Practice Address - Street 2:STE. 150
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-3591
Practice Address - Country:US
Practice Address - Phone:877-784-3667
Practice Address - Fax:586-408-6071
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-12-17
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Provider Licenses
StateLicense IDTaxonomies
MN47385207T00000X
MI4301071763207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q26462Medicare PIN