Individual
CHARLS G BUTTERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
157 TOWNE AVE, PLAINFIELD, VT 05667-9425
(802) 454-8336
(802) 454-8339
Mailing address
PO BOX 320, PLAINFIELD, VT 05667-0320
(802) 454-8336
(802) 454-8339
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
055-0030661
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008900
—
VT
01
—
055-0030661
LICENSE
VT
01
—
367491
MVP
VT
Enumeration date
05/05/2006
Last updated
03/07/2023
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