| Virtual Medical Clinic Llc | |
|
713 Ice House Dr Mountain Top PA 18707-9617 | |
| (570) 843-1972 | |
| Not Available |
| Full Name | Virtual Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 713 Ice House Dr, Mountain Top, Pennsylvania |
| Authorized Official Name and Position | Michael Roberts (OWNER) |
| Authorized Official Contact | 6077255064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virtual Medical Clinic Llc 713 Ice House Dr Mountain Top PA 18707-9617 Ph: (607) 725-5064 | Virtual Medical Clinic Llc 713 Ice House Dr Mountain Top PA 18707-9617 Ph: (570) 843-1972 |
| NPI Number | 1205553229 |
|---|---|
| Provider Enumeration Date | 10/20/2022 |
| Last Update Date | 10/20/2022 |
| Medicare PECOS PAC ID | 3274904305 |
|---|---|
| Medicare Enrollment ID | O20230126003325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205553229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael D Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376861922 PECOS PAC ID: 3476797929 Enrollment ID: I20150806010050 |
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