Individual
MARIE-CLAUDE BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29 RIDGEWOOD RD, SPRINGFIELD, VT 05156-3060
(802) 886-3556
(802) 886-2535
Mailing address
PO BOX 1612, BRATTLEBORO, VT 05302-1612
(802) 886-3556
(802) 886-2535
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101252507
VA
208800000X
Urology Physician
Primary
042-0010862
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011134
—
VT
05
—
1477583250
—
VA
05
—
3070634
—
NH
Enumeration date
07/04/2006
Last updated
05/15/2014
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