Provider Demographics
NPI:1003997644
Name:SASSER, FRANK MATTHEWS JR (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:MATTHEWS
Last Name:SASSER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16644 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-2600
Mailing Address - Country:US
Mailing Address - Phone:804-883-5374
Mailing Address - Fax:804-883-7291
Practice Address - Street 1:16644 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2600
Practice Address - Country:US
Practice Address - Phone:804-883-5374
Practice Address - Fax:804-883-7291
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101012609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5605636Medicaid
VA5605636Medicaid
VA080007312Medicare ID - Type Unspecified