MEDICARE: CARDIOVASCULAR ASSOCIATES OF THE VI, PLLC

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	207RC0000X	Cardiovascular Disease Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1871664383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR ASSOCIATES OF THE VI, PLLC

Provider Business Mailing Address
First Line	:	4100 SION FARM SHOPP CTR
Second Line	:	SUITE #5
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4433
Country	:	US
Telephone Number	:	340-713-7000
Fax Number	:	340-713-7001

Provider Business Practice Location Address
First Line	:	4100 SION FARM SHOPP CTR
Second Line	:	SUITE #5
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4433
Country	:	US
Telephone Number	:	340-713-7000
Fax Number	:	340-713-7001

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KENDALL M GRIFFITH
Credential	:	M.D.
Telephone Number	:	340-713-7000

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	12/17/2007

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