# PEDIATRIC MEDICINE, PLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487701140
- **Authorized official:** MS. LISA RENEE BUSHEE (BUSINESS MANAGER)
- **Authorized official phone:** (802) 864-5004

## Contact information

- **Practice address:** 52 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
- **Practice address phone:** (802) 864-5004
- **Practice address fax:** (802) 863-6933
- **Mailing address:** 52 TIMBER LN, SOUTH BURLINGTON, VT 05403-7204
- **Mailing address phone:** (802) 864-5004
- **Mailing address fax:** (802) 863-6933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 08/22/2020