Marcy, Theodore Wendell

Marcy, Theodore Wendell is an individual health care provider with primary practice located at 111 Colchester Ave Acc East Pavilion 5, Burlington VT 05401-1473. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Marcy, Theodore Wendell can be contacted via phone (802) 847-1158.

Contact Information

Primary practice address
111 Colchester Ave Acc East Pavilion 5 Burlington VT 05401-1473
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X VT 042 0008686 Vermont

Profile Details

NPI number 1508874314
LBN Legal business name Marcy, Theodore Wendell
Credentials MD, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508874314 NPPES
New York MEDICAID 01385033
New York MEDICAID 0VN0575

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