Healthcare Provider Details

I. General information

NPI: 1104382001
Provider Name (Legal Business Name): VPA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 E SHEA BLVD STE 200266
PHOENIX AZ
85028-3345
US

IV. Provider business mailing address

500 KIRTS BLVD STE 100
TROY MI
48084-4135
US

V. Phone/Fax

Practice location:
  • Phone: 480-977-6000
  • Fax:
Mailing address:
  • Phone: 248-824-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM F SASSER JR.
Title or Position: OWNER
Credential: MD
Phone: 248-824-6000