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General NPI Number Information
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NPI Number | 1639134596
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Entity Type | Individual
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Provider Name | SARA A QUAYLE MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 51 TIMBER LN
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-5201
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Country | US
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Telephone | 802-864-0521
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Fax | 802-864-6475
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Provider Business Mailing Address
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Address Line | 600 BLAIR PARK RD SUITE 190
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City | WILLISTON
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State | VT
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Zip | 05495-7586
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Country | US
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Telephone | 802-872-4343
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Fax | 802-872-0282
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 042-0007533
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License Number State | VT
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