Healthcare Provider Details

I. General information

NPI: 1982349254
Provider Name (Legal Business Name): ANESTHESIA ASSOCIATES OF VERMONT PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/14/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 HERCULES DR
COLCHESTER VT
05446-5993
US

IV. Provider business mailing address

PO BOX 158
WINOOSKI VT
05404-0158
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-5350
  • Fax: 802-338-9390
Mailing address:
  • Phone: 802-316-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINCENT J. MILLER
Title or Position: MANAGER
Credential: MD
Phone: 802-316-1467