Healthcare Provider Details
I. General information
NPI: 1972517845
Provider Name (Legal Business Name): VPA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2205 JOLLY RD
OKEMOS MI
48864-3983
US
IV. Provider business mailing address
PO BOX 1500
NOVI MI
48376-1500
US
V. Phone/Fax
- Phone: 517-347-4085
- Fax: 517-347-4170
- Phone: 248-324-0700
- Fax: 248-324-1477
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: DR.
WILLIAM
F
SASSER
JR.
Title or Position: OWNER
Credential: MD
Phone: 248-824-6600