Provider Demographics
NPI:1720050909
Name:MINIER, VERONICA S (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:S
Last Name:MINIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:S
Other - Last Name:ZMAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:844 OLD TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-8524
Mailing Address - Country:US
Mailing Address - Phone:530-274-9762
Mailing Address - Fax:530-273-7255
Practice Address - Street 1:844 OLD TUNNEL RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-8524
Practice Address - Country:US
Practice Address - Phone:530-274-9762
Practice Address - Fax:530-273-7255
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABC60280636207Q00000X
WAMD60266127207Q00000X
CAA70520207Q00000X
WI46182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0294400OtherL&I
WI34441800Medicaid
WA1720050909Medicaid
H80245Medicare UPIN
WAG8908525Medicare PIN
WA1720050909Medicaid