Dr Miriam Blodgett Tatum, MD - Pediatrics in Derby Line, VT

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Dr Miriam Blodgett Tatum, MD is a Pediatrics - Adolescent Medicine physician based in Derby Line, Vermont. Dr Miriam Blodgett Tatum is licensed to practice in Vermont (license number 042-0008370) and her current practice location is 159 Main Street, Derby Line, Vermont. She can be reached at her office (for appointments etc.) via phone at (802) 873-3009.

NPI number for Dr Miriam Blodgett Tatum is 1770682106 and her current mailing address is Po Box 970, 159 Main Street, Derby Line, Vermont. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770682106.

Contact Information

Dr Miriam Blodgett Tatum, MD
159 Main Street,
Derby Line, VT 05830
(802) 873-3009
Not Available

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Physician's Profile

Full NameDr Miriam Blodgett Tatum
GenderFemale
SpecialityPediatrics - Adolescent Medicine
Location159 Main Street, Derby Line, Vermont
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1770682106
  • Provider Enumeration Date: 09/22/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Miriam Blodgett Tatum such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1770682106NPI-NPPES
042-0008370OtherVTSTATE LICENSE NUMBER
0VN0264MedicaidVT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2080A0000XPediatrics - Adolescent Medicine 042-0008370 (Vermont)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Miriam Blodgett Tatum is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Miriam Blodgett Tatum, MD
Po Box 970, 159 Main Street,
Derby Line, VT 05830-0970

Ph: (802) 873-3009		Dr Miriam Blodgett Tatum, MD
159 Main Street,
Derby Line, VT 05830

Ph: (802) 873-3009

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Pediatrics Doctors in Derby Line, VT


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