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NPI Code Detail

MEDICARE: VPA PC

MEDICARE: VPA PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2207R00000XInternal Medicine Physician
3208D00000XGeneral Practice Physician
4207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336153295
Entity Type Code : Organization
Provider Name (Legal Business Name) : VPA PC
Provider Business Mailing Address
First Line : PO BOX 40412
Second Line :
City : BELFAST
State : ME
Zip : 04915-1255
Country : US
Telephone Number : 734-975-5000
Fax Number : 734-975-0376
Provider Business Practice Location Address
First Line : 500 KIRTS BLVD
Second Line : SUITE 200
City : TROY
State : MI
Zip : 48084-4134
Country : US
Telephone Number : 248-824-6060
Fax Number : 248-686-0772
Authorized Official
Title or Position : OWNER
Name : DR. JEFFREY STEVENS
Credential : DO
Telephone Number : 248-824-6000
Provider Enumeration Date : 07/28/2006
Last Update Date : 03/23/2026

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1629172317 — RONALDO SAN JUAN MD
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1871666784 — VPA PC
Practice Location Address:
500 KIRTS BLVD
TROY, MI
48084-4134
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Directions to “VPA PC ” Practice Location

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