Individual
DR. SHERRI LYN DEHAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
148 CONVENT AVE, BENNINGTON, VT 05201-1709
(802) 753-7553
(802) 753-7553
Mailing address
148 CONVENT AVE, BENNINGTON, VT 05201-1709
(802) 753-7553
(802) 753-7553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0011611
VT
207Q00000X
Family Medicine Physician
60 249093
NY
207Q00000X
Family Medicine Physician
MD-074113-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019050740008
—
PA
01
—
080185013
RR MEDICARE
—
01
—
55470
GEISINGER
PA
01
—
7473379
AETNA
PA
01
—
925577
BC/BS
PA
01
—
P004532
GATEWAY
—
Enumeration date
08/31/2005
Last updated
07/30/2013
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