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Individual

EVAN MUSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
ONE KENNEDY DRIVE, SUITE U-1, SOUTH BURLINGTON, VT 05403-7166
(802) 861-6100
(802) 861-6101
Mailing address
ONE KENNEDY DRIVE, SUITE U-1, SOUTH BURLINGTON, VT 05403-7166
(802) 861-6100
(802) 861-6101

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
032-0000427
VT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
032-0000427
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
364858
MVP
VT
01
39879
BC BS OF VT
VT
01
P00301582
RR MEDICARE
VT
Enumeration date
01/29/2007
Last updated
03/05/2008
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