# SUSANNA THACH MD PLC

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

## Provider details

- **NPI number:** 1932846797
- **Authorized official:** SUSANNA BRADLEY THACH M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (314) 780-6582

## Contact information

- **Practice address:** 43 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
- **Practice address phone:** (802) 860-3940
- **Practice address fax:** (802) 448-3765
- **Mailing address:** 43 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
- **Mailing address phone:** (802) 495-0940
- **Mailing address fax:** (802) 448-3765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2022
- **Last updated:** 09/05/2025