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Individual

SEAN C O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1311 BARRE-MONTPELIER RD, STE 200, BERLIN, VT 05602-0000
(802) 371-4239
(802) 371-4237
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 371-4239
(802) 371-4237

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031197
VT
363AM0700X
Medical Physician Assistant
0895
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000735
VT
Enumeration date
05/22/2012
Last updated
06/26/2015
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