Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 042-0011132 | VT |
Y | 208600000X | Surgeon | 042-0011132 | VT |
NPI | 1003883869 |
---|---|
Provider Name | Dr. Eric James Marsh |
First Address | Rutland, VT 05701-4601 |
Second Address | Rutland, VT 05701-4601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 27/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1012630 | (05) | VT |
I36117 | (02) | VT |