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NPI Code Detail

MEDICARE: VIRTUOUS MEDICAL ASSOCIATES, LLC

MEDICARE: VIRTUOUS MEDICAL ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204R00000XElectrodiagnostic Medicine Physician

General Provider Information

NPI Number : 1720549090
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRTUOUS MEDICAL ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 610 E BASELINE RD
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1204
Country : US
Telephone Number : 602-603-0360
Fax Number :
Provider Business Practice Location Address
First Line : 610 E BASELINE RD
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1204
Country : US
Telephone Number : 602-603-0360
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : SUSAN NANCE
Credential : RN
Telephone Number : 602-903-0360
Provider Enumeration Date : 03/28/2019
Last Update Date : 05/12/2026

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Directions to “VIRTUOUS MEDICAL ASSOCIATES, LLC ” Practice Location

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