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General NPI Number Information
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NPI Number | 1891740775
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Entity Type | Individual
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Provider Name | DIANE CHARLAND M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 71 KNIGHT LN SUITE 10
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City | WILLISTON
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State | VT
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Zip | 05495-4432
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Country | US
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Telephone | 802-872-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 71 KNIGHT LN SUITE 10
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City | WILLISTON
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State | VT
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Zip | 05495-4432
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Country | US
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Telephone | 802-872-7001
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 0420010080
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0420010080
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License Number State | VT
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