MEDICARE: VPG 1, LLC

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
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1649422353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VPG 1, LLC

Provider Business Mailing Address
First Line	:	300 VILLAGE GREEN CIRCLE
Second Line	:	SUITE 200
City	:	SMYRNA
State	:	GA
Zip	:	30080-3451
Country	:	US
Telephone Number	:	770-384-0284
Fax Number	:	404-446-1957

Provider Business Practice Location Address
First Line	:	105 COLLIER RD NW
Second Line	:	SUITE 3060
City	:	ATLANTA
State	:	GA
Zip	:	30309-1710
Country	:	US
Telephone Number	:	404-446-1890
Fax Number	:	404-351-3196

Authorized Official
Title or Position	:	C.E.O.
Name	:	DAVID N. HELFMAN
Credential	:	D.P.M.
Telephone Number	:	770-384-0284

Provider Enumeration Date	:	10/14/2008
Last Update Date	:	10/14/2008

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