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NPI Code Detail

MEDICARE: DR. CHERI ANN BRODHURST M.D.

MEDICARE: DR. CHERI ANN BRODHURST M.D.
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
1174400000XSpecialist0420006376VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518986744
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHERI ANN BRODHURST M.D.
Provider Business Mailing Address
First Line : 387 CANAL ST
Second Line :
City : BRATTLEBORO
State : VT
Zip : 05301-6616
Country : US
Telephone Number : 802-254-2324
Fax Number : 802-257-9164
Provider Business Practice Location Address
First Line : 387 CANAL ST
Second Line :
City : BRATTLEBORO
State : VT
Zip : 05301-6616
Country : US
Telephone Number : 802-254-2324
Fax Number : 802-257-9164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/08/2007

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