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NPI Code Detail

MEDICARE: DR. TANIA FERNANDEZ BERTSCH MD

MEDICARE:  DR. TANIA FERNANDEZ BERTSCH  MD
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
1207R00000XInternal Medicine Physician420006953VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
242-0006953OTHERVTSTATE LICENSE

General Provider Information

NPI Number : 1124045208
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TANIA FERNANDEZ BERTSCH MD
Provider Business Mailing Address
First Line : 44 HILL RD
Second Line :
City : SOUTH HERO
State : VT
Zip : 05486-4112
Country : US
Telephone Number : 802-372-5873
Fax Number :
Provider Business Practice Location Address
First Line : 87 MAIN ST
Second Line :
City : ESSEX JCT
State : VT
Zip : 05452-3234
Country : US
Telephone Number : 802-847-8354
Fax Number : 802-847-6575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 03/07/2023

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Directions to “ DR. TANIA FERNANDEZ BERTSCH MD” Practice Location

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