Healthcare Provider Details

I. General information

NPI: 1396703484
Provider Name (Legal Business Name): MITCHELL HON-BING TSAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FAHC, DEPARTMENT OF ANESTHESIOLOGY 111 COLCHESTER AVE, WPP2
BURLINGTON VT
05405-0001
US

IV. Provider business mailing address

28 CABOT CT
SOUTH BURLINGTON VT
05403-8500
US

V. Phone/Fax

Practice location:
  • Phone: 802-316-0319
  • Fax:
Mailing address:
  • Phone: 802-316-0319
  • Fax: 802-847-5324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number042-0011115
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: