Individual
THOMAS W YURISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 PORTER DR, PORTER HOSPITAL, MIDDLEBURY, VT 05753
(802) 388-4001
(802) 388-5612
Mailing address
115 PORTER DR, C/O SUSAN SPITZNER FINANCE DEPT, MIDDLEBURY, VT 05753
(802) 388-5607
(802) 388-5654
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0420008282
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18182
BCBS
VT
01
—
77V132
MVP VT MGD CARE
VT
05
—
OVN0146
—
VT
Enumeration date
09/11/2006
Last updated
07/08/2007
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