Provider Demographics
NPI:1750568531
Name:WILKS, VEENU GAREWAL (MD)
Entity type:Individual
Prefix:
First Name:VEENU
Middle Name:GAREWAL
Last Name:WILKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1905 DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1212
Mailing Address - Country:US
Mailing Address - Phone:631-664-6173
Mailing Address - Fax:
Practice Address - Street 1:75 SOCKANOSSET CROSS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5558
Practice Address - Country:US
Practice Address - Phone:401-946-6200
Practice Address - Fax:401-275-1992
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD12807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1750568531Medicaid
RI05-0483739OtherTAX ID #