Individual
MARIAN PETRIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
39 WILD TURKEY LN, WAITSFIELD, VT 05673-7348
(802) 496-6175
Mailing address
39 WILD TURKEY LN, WAITSFIELD, VT 05673-7348
(802) 496-6175
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
042-0006038
VT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
042-0006038
VT
Other
Enumeration date
05/20/2006
Last updated
03/01/2012
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