Basic Information
| Provider Information | |||||||||
| NPI: | 1902361777 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VPA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 KIRTS BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007597291 | ||||||||
| FaxNumber: | 2488240630 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 KIRTS BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007597291 | ||||||||
| FaxNumber: | 2488240630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2019 | ||||||||
| LastUpdateDate: | 02/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | SASSER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8007597291 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085U0001X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No ID Information.