Individual
DR. MARK PHILLIPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, FAHC, ACC EP-4, BURLINGTON, VT 05401-1473
(802) 847-5112
(802) 847-5626
Mailing address
74 WILDWOOD DR, SHELBURNE, VT 05482-6787
(802) 985-3115
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
042-0010320
VT
207VM0101X
Maternal & Fetal Medicine Physician
042-0010320
VT
207VX0000X
Obstetrics Physician
Primary
042-0010320
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02210319
NY MEDICAID
NY
05
—
1008327
—
VT
Enumeration date
07/26/2006
Last updated
09/11/2025
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