Individual
RICHARD N CLATTENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1067 CADY HILL RD, PERKINSVILLE, VT 05151-9523
(802) 263-5505
(802) 263-5594
Mailing address
1067 CADY HILL RD, PERKINSVILLE, VT 05151-9523
(802) 263-5505
(802) 263-5594
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
0420006288
VT
208000000X
Pediatrics Physician
042-0006288
VT
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
042-0006288
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005110
—
VT
Enumeration date
09/19/2005
Last updated
06/02/2011
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