Healthcare Provider Details

I. General information

NPI: 1972796167
Provider Name (Legal Business Name): STEVEN ADES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE HEMATOLOGY/ONCOLOGY, ACC LEVEL 2
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

89 BEAUMONT AVE GIVEN BLDG, E-214
BURLINGTON VT
05405-1742
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-8400
  • Fax:
Mailing address:
  • Phone: 802-847-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number042-0011407
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: