Healthcare Provider Details

I. General information

NPI: 1619807385
Provider Name (Legal Business Name): MMC PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 BONNET ST
MANCHESTER CENTER VT
05255-8920
US

IV. Provider business mailing address

34 BONNET ST
MANCHESTER CENTER VT
05255-8920
US

V. Phone/Fax

Practice location:
  • Phone: 802-768-1718
  • Fax:
Mailing address:
  • Phone: 802-768-1718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS STERLING
Title or Position: OWNER
Credential: MD
Phone: 440-487-0489