Healthcare Provider Details

I. General information

NPI: 1427021286
Provider Name (Legal Business Name): JOHN ANDREW DRESLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD, MOB-C,STE 1 CVMC UROLOGY
BERLIN VT
05602-9000
US

IV. Provider business mailing address

PO BOX 547 ATT: CVMC FINANCE DEPT
BARRE VT
05641-0547
US

V. Phone/Fax

Practice location:
  • Phone: 802-371-4820
  • Fax: 802-371-4855
Mailing address:
  • Phone: 802-371-4820
  • Fax: 802-371-4855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD11886
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number042.0013279
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: