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Individual

DR. DIANE CHARLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
71 KNIGHT LN, SUITE 10, WILLISTON, VT 05495-4432
(802) 872-7001
Mailing address
71 KNIGHT LN, SUITE 10, WILLISTON, VT 05495-4432
(802) 872-7001

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
0420010080
VT
208800000X
Urology Physician
Primary
0420010080
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0VN2378
VT
01
P00244985
RAIL ROAD MEDICARE
VT
Enumeration date
05/22/2006
Last updated
01/09/2008
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