Healthcare Provider Details

I. General information

NPI: 1902356215
Provider Name (Legal Business Name): VIRTUA MEDICAL GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 LINCOLN DR W LOWR LEVEL
MARLTON NJ
08053-1800
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 855-548-7634
  • Fax: 856-355-7127
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNJ

VIII. Authorized Official

Name: JOHN MARK MATSINGER
Title or Position: EVP AND COO
Credential: DO
Phone: 856-355-0340