Individual
MICHEAL R SIROIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 WILLISTON RD, SOUTH BURLINGTON, VT 05403-6491
(802) 847-8500
(802) 860-4324
Mailing address
213 APPLE RIDGE RD, HINESBURG, VT 05461-4417
(802) 658-4180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420007821
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009539
—
VT
01
—
01425
BLUE CROSS BLUE SHIELD
VT
01
—
08510
MVP
VT
01
—
VT9535
TRICARE
—
Enumeration date
06/09/2006
Last updated
01/15/2010
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