Bisanzo, Mark C.
Bisanzo, Mark C. is an individual health care provider with primary practice located at 111 Colchester Ave. Uvm Medical Center - Dept. Of Surgery/Ed, Burlington VT 05401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Bisanzo, Mark C. can be contacted via phone (802) 847-2434.Contact Information
Primary practice address
111 Colchester Ave. Uvm Medical Center - Dept. Of Surgery/Ed
Burlington VT 05401
Phone: (802) 847-2434
Fax: (802) 847-4802
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 042-0013299 | Vermont |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 44481 | Connecticut |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 222871 | Massachusetts |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 222871 | Massachusetts |
Profile Details
| NPI number | 1740249226 |
|---|---|
| LBN Legal business name | Bisanzo, Mark C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | May 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740249226 | NPPES |
| Massachusetts | MEDICAID | 110075594A |
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