Provider Demographics
NPI:1982699427
Name:ARTUSIO, JOSEPH F (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:ARTUSIO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 BRAEBURN DR
Mailing Address - Street 2:SUITE 1310
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7357
Mailing Address - Country:US
Mailing Address - Phone:540-776-2020
Mailing Address - Fax:540-776-2017
Practice Address - Street 1:1802 BRAEBURN DR
Practice Address - Street 2:SUITE 1310
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7357
Practice Address - Country:US
Practice Address - Phone:540-776-2020
Practice Address - Fax:540-776-2017
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01100000052363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982699427Medicaid
VA010245818Medicaid
VAP00459875Medicare PIN
VA016110S90Medicare PIN
P00191171Medicare PIN
VA1982699427Medicaid
VVA873AMedicare PIN
VA010245818Medicaid