Individual
STEPHANIE J LANDVATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2418 AIRPORT RD STE C, BARRE, VT 05641-8702
(802) 881-5137
(802) 433-5070
Mailing address
507 CHAPMAN LN, WILLISTON, VT 05495-7770
(802) 881-5137
(802) 433-5070
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042000860
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689662215
—
VT
01
—
18304
MVP
VT
01
—
18693
BLUE CROSS/BLUE SHIELD/VT
VT
05
—
OVN0439
—
VT
Enumeration date
10/07/2005
Last updated
07/18/2019
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