Individual
DR. GARTH GARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-1158
Mailing address
883 E LAKESHORE DR, COLCHESTER, VT 05446-7798
(734) 730-8079
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
042-0012261
VT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301085778
MI
207RP1001X
Pulmonary Disease Physician
Primary
042-0012261
VT
390200000X
Student in an Organized Health Care Education/Training Program
4301085778
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM - BMH TAX ID
MI
05
—
1427175330
—
MI
Enumeration date
03/23/2007
Last updated
09/04/2011
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