Provider Demographics
NPI:1962415653
Name:VEGESINA, VASUNDHARA D (RN)
Entity type:Individual
Prefix:
First Name:VASUNDHARA
Middle Name:D
Last Name:VEGESINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ESTER
Other - Middle Name:D
Other - Last Name:VEGESINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:2868 ACTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243
Mailing Address - Country:US
Mailing Address - Phone:205-968-8360
Mailing Address - Fax:205-968-8375
Practice Address - Street 1:2868 ACTON ROAD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243
Practice Address - Country:US
Practice Address - Phone:205-968-8360
Practice Address - Fax:205-968-8375
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0556902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry