Healthcare Provider Details

I. General information

NPI: 1750323903
Provider Name (Legal Business Name): VI NEUROLOGICAL MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UPPERHAVENSITE BLD3 305
ST THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 8739
ST THOMAS VI
00801-1739
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-3633
  • Fax: 340-776-2552
Mailing address:
  • Phone: 340-775-4363
  • Fax: 340-776-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES D NELSON
Title or Position: OWNER
Credential: M.D.
Phone: 340-774-3633