Individual
DR. MARY CUSHMAN
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) 847-8400
(802) 847-1258
Mailing address
264 LITTLEFIELD DR, SHELBURNE, VT 05482-6357
(802) 985-1107
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
0420008994
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01593957
—
NY
05
—
1160
—
VT
Enumeration date
10/04/2006
Last updated
07/09/2007
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