Individual
BELLE TRAVER MCDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
192 TILLEY DR, SOUTH BURLINGTON, VT 05403-4440
(802) 847-4914
(802) 847-7470
Mailing address
192 TILLEY DR, SOUTH BURLINGTON, VT 05403-4440
(802) 847-4914
(802) 847-7470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030428
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00019672
BLUE CROSS
VT
05
—
9000314
—
VT
Enumeration date
05/18/2006
Last updated
12/04/2014
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