Healthcare Provider Details

I. General information

NPI: 1053104604
Provider Name (Legal Business Name): VIRTUA MEDICAL GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWMAN DR STE E340B
VOORHEES NJ
08043-9623
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7465
  • Fax: 856-762-0751
Mailing address:
  • Phone: 856-355-3340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: JOHN MARK MATSINGER
Title or Position: EVP; CHIEF OPERATING OFFICER
Credential: DO
Phone: 856-355-0340