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Organization

GREEN MOUNTAIN GENERAL SURGERY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN F SMALE MD (PRESIDENT)
(802) 888-2311
Entity
Organization

Contact information

Practice address
530 WASHINGTON HIGHWAY, HEALTH CENTER BUILDING SUITE 3, MORRISVILLE, VT 05661
(802) 888-2311
(802) 888-0031
Mailing address
530 WASHINGTON HIGHWAY, SUITE 3, MORRISVILLE, VT 05661
(802) 888-2311
(802) 888-0031

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009478
VT
01
DA5793
RAILROAD MEDICARE
01
GREE00059225
BLUE CROSS BLUE SHIELD
VT
Enumeration date
06/06/2006
Last updated
08/22/2020
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