Healthcare Provider Details

I. General information

NPI: 1427752229
Provider Name (Legal Business Name): EMMA CLAUSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA GUTIERREZ-CLAUSEN MD

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 EXCHANGE ST
MIDDLEBURY VT
05753-4464
US

IV. Provider business mailing address

1330 EXCHANGE ST STE 201
MIDDLEBURY VT
05753-4464
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-1500
  • Fax: 802-388-0441
Mailing address:
  • Phone: 802-388-1500
  • Fax: 802-388-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0420040632
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: