Healthcare Provider Details

I. General information

NPI: 1073537858
Provider Name (Legal Business Name): ANNA CAREY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 NORTH MAIN ST.
CAMBRIDGE VT
05444
US

IV. Provider business mailing address

PO BOX 102
CAMBRIDGE VT
05444-0102
US

V. Phone/Fax

Practice location:
  • Phone: 802-633-5114
  • Fax: 802-644-5573
Mailing address:
  • Phone: 802-644-5114
  • Fax: 802-644-5573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number420008840
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: