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General NPI Number Information
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NPI Number | 1093657231
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Entity Type | Organization
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Legal Business Name | ADVANCED PRIMARY CARE PC
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 462 SHELBURNE RD STE 102
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City | BURLINGTON
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State | VT
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Zip | 05401-6947
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Country | US
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Telephone | 802-227-4417
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Fax |
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Provider Business Mailing Address
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Address Line | 462 SHELBURNE RD STE 102
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City | BURLINGTON
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State | VT
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Zip | 05401-6947
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Country | US
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Telephone | 802-227-4417
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SPENCER LEE BLACKMAN
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Credential | MD
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Telephone | 802-227-4417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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