Individual
SUSAN WHITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
425 PEARL ST, BURLINGTON, VT 05401-3308
(802) 656-3350
(802) 656-8001
Mailing address
1450 JOHNNIE BROOK RD, RICHMOND, VT 05477-4412
(802) 578-5146
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0550030747
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030747
FLETCHER ALLEN PREFERRED
—
01
—
69001
BLUE CROSS BLUE SHIELD
—
01
—
793628
MVP
—
05
—
9000241
—
VT
Enumeration date
09/26/2006
Last updated
09/04/2012
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