Individual
DR. MARK DAVID CHARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
192 TILLEY DR, SOUTH BURLINGTON, VT 05403-4440
(802) 847-2663
(802) 847-3797
Mailing address
192 TILLEY DR, SOUTH BURLINGTON, VT 05403-4440
(802) 847-2663
(802) 847-3797
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
200400468
NC
207X00000X
Orthopaedic Surgery Physician
42-0011585
VT
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
42-0011585
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015272
—
VT
Enumeration date
05/18/2006
Last updated
09/25/2012
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