Individual
MARK IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
81 RIVER ST, SUITE 204, MONTPELIER, VT 05602-3792
(802) 229-9554
(802) 229-5906
Mailing address
81 RIVER ST, SUITE 204, MONTPELIER, VT 05602-3792
(802) 229-9554
(802) 229-5906
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
042.0007517
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009051
—
VT
Enumeration date
04/03/2006
Last updated
11/03/2016
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