Border Pediatrics | |
159 Main St Derby Line VT 05830-8754 | |
(802) 873-3009 | |
(802) 873-3176 |
Full Name | Border Pediatrics |
---|---|
Speciality | Pediatrics - Adolescent Medicine |
Location | 159 Main St, Derby Line, Vermont |
Authorized Official Name and Position | Miriam Blodgett Tatum (PRESIDENT) |
Authorized Official Contact | 8028733009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Border Pediatrics 159 Main St Derby Line VT 05830-8754 Ph: (802) 873-3009 | Border Pediatrics 159 Main St Derby Line VT 05830-8754 Ph: (802) 873-3009 |
NPI Number | 1750483780 |
---|---|
Provider Enumeration Date | 09/01/2006 |
Last Update Date | 01/04/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750483780 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 042-0008363 (Vermont) | Secondary |
2080A0000X | Pediatrics - Adolescent Medicine | 042-0008370 (Vermont) | Primary |