Healthcare Provider Details

I. General information

NPI: 1871664383
Provider Name (Legal Business Name): CARDIOVASCULAR ASSOCIATES OF THE VI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SION FARM SHOPP CTR SUITE #5
CHRISTIANSTED VI
00820-4433
US

IV. Provider business mailing address

4100 SION FARM SHOPP CTR SUITE #5
CHRISTIANSTED VI
00820-4433
US

V. Phone/Fax

Practice location:
  • Phone: 340-713-7000
  • Fax: 340-713-7001
Mailing address:
  • Phone: 340-713-7000
  • Fax: 340-713-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENDALL M GRIFFITH
Title or Position: OWNER
Credential: M.D.
Phone: 340-713-7000