Healthcare Provider Details

I. General information

NPI: 1376022814
Provider Name (Legal Business Name): HOSPITALIST MEDICINE PHYSICIANS OF VERMONT-TCG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 FAIRFIELD ST
SAINT ALBANS VT
05478-1726
US

IV. Provider business mailing address

120 BRENTWOOD COMMONS WAY STE 510
BRENTWOOD TN
37027-2028
US

V. Phone/Fax

Practice location:
  • Phone: 802-524-5911
  • Fax:
Mailing address:
  • Phone: 615-377-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HARLAN
Title or Position: DIRECTOR
Credential:
Phone: 615-577-6340