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NPI Code Detail

MEDICARE: KIPP EDWARD VANMETER DO

MEDICARE:   KIPP EDWARD VANMETER  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician054570CT

General Provider Information

NPI Number : 1013145101
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIPP EDWARD VANMETER DO
Provider Business Mailing Address
First Line : HARTFORD HEALTHCARE URGENT CARE
Second Line : 339 WEST MAIN STREET
City : AVON
State : CT
Zip : 06001
Country : US
Telephone Number : 860-696-4460
Fax Number :
Provider Business Practice Location Address
First Line : 117 ALBANY TPKE
Second Line :
City : CANTON
State : CT
Zip : 06019-2507
Country : US
Telephone Number : 860-658-3444
Fax Number : 860-658-3458
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2009
Last Update Date : 05/22/2019

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Directions to “ KIPP EDWARD VANMETER DO” Practice Location

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