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General NPI Number Information
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NPI Number | 1497200661
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Entity Type | Individual
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Provider Name | DEVON ERIC ANDERSON MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1436 EXCHANGE ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-4497
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Country | US
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Telephone | 803-388-3194
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 EXCHANGE ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-4497
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Country | US
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Telephone | 803-388-3194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 042.0017712
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License Number State | VT
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