Garrison, Garth
Garrison, Garth is an sole proprietor health care provider with primary practice located at 111 Colchester Ave , Burlington VT 05401-1473. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Garrison, Garth can be contacted via phone (802) 847-1158.Contact Information
Primary practice address
111 Colchester Ave
Burlington VT 05401-1473
Phone: (802) 847-1158
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 4301085778 | Michigan |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 4301085778 | Michigan |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 042-0012261 | Vermont |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 042-0012261 | Vermont |
Profile Details
| NPI number | 1427175330 |
|---|---|
| LBN Legal business name | Garrison, Garth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 23rd, 2007 |
| Last updated | Sep 4th, 2011 - about 14 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 | 1427175330 | NPPES |
| Michigan | Other | 1417961137 | BCBSM - BMH TAX ID |
| Michigan | MEDICAID | 1427175330 | BCBSM - BMH TAX ID |
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