Individual
PEDRO VINICIUS STAZIAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
268556
MA
2085R0202X
Diagnostic Radiology Physician
Primary
042-0015695
VT
2085R0202X
Diagnostic Radiology Physician
268556
MA
Other
Enumeration date
06/27/2016
Last updated
07/15/2022
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