Healthcare Provider Details

I. General information

NPI: 1861280463
Provider Name (Legal Business Name): 540 CLINICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 AMBLER LN
SALEM VA
24153-1103
US

IV. Provider business mailing address

717 AMBLER LN
SALEM VA
24153-1103
US

V. Phone/Fax

Practice location:
  • Phone: 804-229-4874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL SAPP
Title or Position: PHYSICIAN
Credential: DO
Phone: 804-229-4874