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General NPI Number Information
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NPI Number | 1366690190
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANESTHESIA OF VERMONT, PLC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 1100 HINESBURG RD
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7613
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Country | US
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Telephone | 802-985-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 5224 SHELBURNE RD
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City | SHELBURNE
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State | VT
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Zip | 05482-6621
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Country | US
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Telephone | 802-985-1488
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. EDWARD POMICTER
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Credential | M.D.
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Telephone | 802-985-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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