Healthcare Provider Details

I. General information

NPI: 1942882329
Provider Name (Legal Business Name): GEORGE CAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVENUE, SHEPARDSON 567 INTERNAL MEDICINE
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-7911
  • Fax:
Mailing address:
  • Phone: 802-847-7911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number042.0017941
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: