Individual
DR. JENNIFER CERNY GAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
Mailing address
PO BOX 36351, SOUTHEAST ANESTHESIOLOGY CONSULTANTS PA, CHARLOTTE, NC 28236-6351
(704) 377-5772
(704) 377-3389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
042.0014182
VT
207L00000X
Anesthesiology Physician
9300390
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911269
—
NC
01
—
N00390
MEDICAID
SC
Enumeration date
10/10/2005
Last updated
12/05/2018
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