Individual
ANDREA ELIZABETH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 SOUTH PROSPECT STREET, UHC PEDIATRICS, BURLINGTON, VT 05401
(802) 847-4696
Mailing address
239 RIDGE RD, CHARLOTTE, VT 05445-9071
(802) 425-7374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-0010520
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009409
—
VT
Enumeration date
08/01/2006
Last updated
07/09/2007
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