Healthcare Provider Details

I. General information

NPI: 1265512644
Provider Name (Legal Business Name): JAMIE ALPERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE WEST PAVLILION 5
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

34 N OLDE CARRIAGE RD
CHARLOTTE VT
05445-9093
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-4570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number042-0008966
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: