Provider Demographics
NPI:1790029320
Name:VPA PC
Entity Type:Organization
Organization Name:VPA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:SASSER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:248-824-6000
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6000
Mailing Address - Fax:855-618-6655
Practice Address - Street 1:263 MCLAWS CIR STE 105
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5674
Practice Address - Country:US
Practice Address - Phone:248-824-6280
Practice Address - Fax:248-269-0631
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VPA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-20
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1790029320Medicaid
VA1790029320Medicaid