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Individual

MARY E GADOS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
23 SAN REMO DR, SUITE 101, SOUTH BURLINGTON, VT 05403-6343
(802) 865-0010
(802) 865-0050
Mailing address
23 SAN REMO DR, SUITE 101, SOUTH BURLINGTON, VT 05403-6343
(802) 865-0010
(802) 865-0050

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
020816-1
NY
174400000X
Specialist
Primary
040-0003314
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00058693
BC/BS
VT
05
1012150
VT
01
385696
MVP
VT
01
OOO3314
VT MANAGED CARE
VT
Enumeration date
05/27/2006
Last updated
07/08/2007
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