Healthcare Provider Details

I. General information

NPI: 1619172590
Provider Name (Legal Business Name): SREE SUSMITHA GARAPATI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SREE SUSMITHA GARAPATI MD

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE. UVM MEDICAL CENTER - MEDICINE/ENDOCRINOLOGY
BURLINGTON VT
05401
US

IV. Provider business mailing address

111 COLCHESTER AVE. UVM MEDICAL CENTER - MEDICINE/ENDOCRINOLOGY
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-4576
  • Fax:
Mailing address:
  • Phone: 802-847-4576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125050070
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number042.0013200
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: