Healthcare Provider Details
I. General information
NPI: 1619989746
Provider Name (Legal Business Name): MURIEL HELENE NATHAN M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/13/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 S PROSPECT ST
BURLINGTON VT
05401-3456
US
IV. Provider business mailing address
302 BRAND FARM DR
SOUTH BURLINGTON VT
05403-7551
US
V. Phone/Fax
- Phone: 802-847-4576
- Fax: 802-847-2226
- Phone: 802-860-1655
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: