Organization
PORTER HOSPITAL INC
Active
Parent organization
PORTER HOSPITAL INC
Other names
Porter Hospital Inc dba Middlebury Pediatric and Adolescent Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PORTER HOSPITAL INC
Authorized official
STEVE CIAMPA (CFO)
(802) 388-4752
Entity
Organization
Contact information
Practice address
1330 EXCHANGE ST, MIDDLEBURY PEDIATRIC AND ADOLESCENT AND MEDICINE, MIDDLEBURY, VT 05753-4464
(802) 388-7959
(802) 388-3380
Mailing address
104 PORTER DRIVE, MIDDLEBURY, VT 05753
(802) 388-5682
(802) 388-5692
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006356
—
VT
Enumeration date
07/20/2006
Last updated
07/25/2013
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