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General NPI Number Information
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NPI Number | 1679581300
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Entity Type | Individual
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Provider Name | PETER PANAGIOTIS METRAKOS MD, FRCSC, FACS
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 S PROSPECT ST UHC CAMPUS, RENAL/TRANSPLANT - 4TH FL
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City | BURLINGTON
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State | VT
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Zip | 05401-3456
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Country | US
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Telephone | 802-847-4548
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Fax | 802-847-3619
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Provider Business Mailing Address
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Address Line | MUHS - RVH SITE S10.26, 687 AVENUE DES PINS O
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City | MONTREAL
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State | QUEBEC
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Zip | H3A 1A1
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Country | CA
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Telephone | 514-843-1600
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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 | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 0420010480
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License Number State | VT
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