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Organization

GREEN MOUNTAIN ORTHOPAEDIC SURGERY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER M. MERIAM M.D. (PRESIDENT)
(802) 229-2663
Entity
Organization

Contact information

Practice address
130 FISHER RD, BUILDING A, SUITE 2-2, BERLIN, VT 05602-9516
(802) 229-2663
Mailing address
130 FISHER RD, BUILDING A, SUITE 2-2, BERLIN, VT 05602-9516
(802) 229-2663

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
6499280001
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009345
VT
05
30216639
NH
01
6499280001
MEDICARE PTAN
VT
Enumeration date
04/18/2006
Last updated
06/03/2015
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