Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 420008086 | VT |
NPI | 1487665261 |
---|---|
Provider Name | David A Halsey |
First Address | South Burlington, VT 05403 |
Second Address | South Burlington, VT 05403-4440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 14/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009323 | (05) | VT |
0107529Y0NH0 | BLUECROSS-ANTHEM (01) | NH |
18P500 | MVP (01) | |
30004156 | (05) | NH |
5281 | CIGNA (01) | |
5382 | BLUECROSS (01) | VT |
E35802 | (02) | VT |