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General NPI Number Information
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NPI Number | 1982067971
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Entity Type | Individual
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Provider Name | MARTHE MELANIE BRYANT CONNAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 82 CATAMOUNT PARK
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1292
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Country | US
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Telephone | 802-388-7185
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 82991
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042-0015779
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License Number State | VT
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