Healthcare Provider Details

I. General information

NPI: 1740253178
Provider Name (Legal Business Name): MAYA P. STRANGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S. PROSPECT ST., ARNOLD 3 UVM MEDICAL CENTER, PSYCHIATRY/CHILD PSYCH.
BURLINGTON VT
05401
US

IV. Provider business mailing address

1 S. PROSPECT ST., ARNOLD 3 UVM MEDICAL CENTER, PSYCHIATRY/CHILD PSYCH.
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-4563
  • Fax: 802-847-7998
Mailing address:
  • Phone: 802-847-4563
  • Fax: 802-847-7998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11860
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number11860
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number042.0013578
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: