Individual
SUSANNA BRADLEY THACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
43 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 495-0940
(802) 448-3765
Mailing address
43 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042.0013606
VT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
2016-02415
NC
Other
Enumeration date
04/01/2013
Last updated
09/05/2025
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