Provider Demographics
NPI:1891430880
Name:SPG VIRTUAL CARE
Entity Type:Organization
Organization Name:SPG VIRTUAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-534-1045
Mailing Address - Street 1:7975 N HAYDEN RD STE D354
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3243
Mailing Address - Country:US
Mailing Address - Phone:480-214-9720
Mailing Address - Fax:480-214-9722
Practice Address - Street 1:7975 N HAYDEN RD STE D354
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3243
Practice Address - Country:US
Practice Address - Phone:480-214-9720
Practice Address - Fax:480-214-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty