Individual
DR. CLARENCE SHERMAN IVIE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 COLCHESTER AVE, WP-2, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-2965
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-2965
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
032-0000512
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013468
—
VT
01
—
VN417801
MEDICARE
VT
Enumeration date
05/16/2006
Last updated
05/23/2013
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