Lake Champlain Gynecologic Oncology, Pc in South Burlington - Physician Assistant
Lake Champlain Gynecologic Oncology, Pc - NPI 1164418455
Lake Champlain Gynecologic Oncology, Pc is a Physician Assistant in South Burlington, Vermont. Lake Champlain Gynecologic Oncology, Pc practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Lake Champlain Gynecologic Oncology, Pc is 1164418455. The last update date is 2013-05-23.
Lake Champlain Gynecologic Oncology, Pc's current location address is 1060 Hinesburg Rd, South Burlington, Vermont. You can contact this provider via phone number 8028599500 and fax number 8028599944. The mailing address for Lake Champlain Gynecologic Oncology, Pc is 1060 Hinesburg Rd, South Burlington, Vermont. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Champlain Gynecologic Oncology, Pc |
|---|---|
| Address | 1060 Hinesburg Rd, South Burlington, Vermont |
| Phone Number | 8028599500 |
| Fax Number | 8028599944 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Eltabbakh H Gamal |
| Credentials | M.D. |
| Telephone Number | 8028599500 |
NPI Number Detail
| NPI Number | 1164418455 |
|---|---|
| Provider Enumeration Date | 2005-09-22 |
| Last Updated Date | 2013-05-23 |
Provider Mailing Address Detail
| Address | 1060 Hinesburg Rd |
|---|---|
| City | South Burlington |
| State | Vermont (VT) |
| Post Code | 54037612 |
| Phone Number | 8028599500 |
| Fax Number | 8028599944 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1760585 | NY | -- | |
| 1008935 | VT | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Lake Champlain Gynecologic Oncology, Pc by the Centers for Medicare & Medicaid Services?
The Lake Champlain Gynecologic Oncology, Pc has been assigned the NPI (National Provider Identifier) 1164418455 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
What is Lake Champlain Gynecologic Oncology, Pc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Lake Champlain Gynecologic Oncology, Pc is Physician Assistant, and the taxonomy code that classifies this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1164418455 to Lake Champlain Gynecologic Oncology, Pc?
The Centers for Medicare & Medicaid Services originally issued the 1164418455 to Lake Champlain Gynecologic Oncology, Pc on 2005-09-22.
As of what date were the details pertaining to Lake Champlain Gynecologic Oncology, Pc last refreshed?
The information related to the Lake Champlain Gynecologic Oncology, Pc, including its address, specialty, and other relevant details, was last updated on 2013-05-23.
When was the information regarding Lake Champlain Gynecologic Oncology, Pc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Lake Champlain Gynecologic Oncology, Pc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2013-05-23.