Individual
MICHAEL E ROBERTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3600
(802) 773-8501
Mailing address
12 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3600
(802) 773-8501
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
042-0009256
VT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
042-0009256
VT
207UN0901X
Nuclear Cardiology Physician
042-0009256
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1371
—
VT
01
—
1824753
CIGNA
—
01
—
28918
BCBS
VT
01
—
351070
MVP
—
Enumeration date
04/11/2006
Last updated
11/13/2018
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