Healthcare Provider Details
I. General information
NPI: 1811944218
Provider Name (Legal Business Name): VPA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4444 W BRISTOL RD STE 330
FLINT MI
48507-3153
US
IV. Provider business mailing address
PO BOX 639295
CINCINNATI OH
45263-9295
US
V. Phone/Fax
- Phone: 810-230-9500
- Fax: 810-230-0169
- Phone: 248-824-6000
- Fax: 855-618-6655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
STEVENS
Title or Position: OWNER
Credential:
Phone: 248-824-6000