Shane, Susan P.

Shane, Susan P. is an individual health care provider with primary practice located at 1 South Prospect Street Fahc Family Medicine, Arnold 4, Burlington VT 05401. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Shane, Susan P. can be contacted via phone (802) 847-4237.

Contact Information

Primary practice address
1 South Prospect Street Fahc Family Medicine, Arnold 4 Burlington VT 05401
Phone: (802) 847-4237
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 042-0007826 Vermont

Profile Details

NPI number 1811959927
LBN Legal business name Shane, Susan P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Oct 4th, 2013 - about 12 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 1811959927 NPPES
Vermont MEDICAID 0009335

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