Individual
MIRABELLE B SAJISEVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-4537
Mailing address
111 COLCHESTER AVENUE, BURLINGTON, VT 05401
(802) 847-4537
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
60326
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2011
Last updated
09/25/2017
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