Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 0047116 | VT |
NPI | 1144424664 |
---|---|
Provider Name | Dr. Michael Stadtmauer |
First Address | South Burlington, VT 05403-7773 |
Second Address | South Burlington, VT 05403-7773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 26/10/2012 |