Individual
KARIN F MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-4910
Mailing address
PO BOX 588, BENNINGTON, VT 05201-0588
(802) 442-5491
(802) 442-4910
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
042-0009090
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1125
—
VT
01
—
10010392
CDPHP
—
01
—
126-1087
BLUE CROSS
VT
01
—
2018556
CIGNA
—
01
—
970368
MVP
—
Enumeration date
07/19/2006
Last updated
07/08/2007
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