Organization
MID VERMONT PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY MASUCK MD (DIRECTOR)
(802) 259-3490
Entity
Organization
Contact information
Practice address
160 ALLEN STREET, RUTLAND REGIONAL MEDICAL CENTER, RUTLAND, VT 05701
(802) 747-1786
(802) 747-6525
Mailing address
160 ALLEN STREET, RUTLAND REGIONAL MEDICAL CENTER, RUTLAND, VT 05701
(802) 747-1786
(802) 747-6525
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN2068
—
VT
Enumeration date
02/05/2007
Last updated
07/30/2019
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