Individual
STEPHANIE COWAN BELLOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
789 PINE ST, BURLINGTON, VT 05401-4933
(802) 864-0693
(802) 860-6613
Mailing address
617 RIVERSIDE AVE, SUITE 190, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0007552
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006487
—
VT
Enumeration date
02/15/2006
Last updated
03/02/2016
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