Healthcare Provider Details

I. General information

NPI: 1629392600
Provider Name (Legal Business Name): LAUREN KELLY MACAFEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2010
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE UNIVERSITY OF VERMONT MEDICAL CENTER
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

111 COLCHESTER AVE UNIVERSITY OF VERMONT MEDICAL CENTER
BURLINGTON VT
05401-1473
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-1400
  • Fax: 802-847-8433
Mailing address:
  • Phone: 802-847-1400
  • Fax: 802-847-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301105545
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number042.0013516
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: