| |
1199 Main St Fairfax VT 05454-9530 | |
(802) 849-2844 | |
(802) 849-2644 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1199 Main St, Fairfax, Vermont |
Authorized Official Name and Position | Teig D Marco (OWNER) |
Authorized Official Contact | 8028492844 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1199 Main St Fairfax VT 05454-9530 Ph: (802) 849-2844 | 1199 Main St Fairfax VT 05454-9530 Ph: (802) 849-2844 |
NPI Number | 1891826780 |
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Provider Enumeration Date | 03/09/2007 |
Last Update Date | 08/14/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891826780 | NPI | - | NPPES |
1020886 | Medicaid | VT | |
0009429 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Fairfax Associates In Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1199 Main St, Fairfax, VT 05454 Phone: 802-849-2844 Fax: 802-849-2644 |