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Individual

MICHAEL JOHN OBERDING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
177851
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001001701
EXCELLUS
NY
05
01132127
NY
01
110315900
US DEPT LABOR
NY
01
177851-1
NYS WORKERS' COMP
NY
Enumeration date
01/23/2006
Last updated
01/05/2009
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