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General NPI Number Information
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NPI Number | 1659187862
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Entity Type | Organization
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Legal Business Name | VI MEDICAL & SURGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 9149 ESTATE THOMAS STE 207
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City | ST THOMAS
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State | VI
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Zip | 00802-3132
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Country | US
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Telephone | 516-972-9869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6785
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City | ST THOMAS
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State | VI
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Zip | 00804-6785
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Country | US
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Telephone | 516-972-9869
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMORY DE ROULET
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Credential | MD MPH
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Telephone | 516-972-9869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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