Basic Information
| Provider Information | |||||||||
| NPI: | 1962511048 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUSHWELLER | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 547 | ||||||||
| Address2: | CVMC MEDICAL GROUP PRACTICES | ||||||||
| City: | BARRE | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056410547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023715326 | ||||||||
| FaxNumber: | 8023715339 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 MAIN ST | ||||||||
| Address2: | MONTPELIER HEALTH CENTER | ||||||||
| City: | MONTPELIER | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056022702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022234738 | ||||||||
| FaxNumber: | 8022236067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 055-0030758 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.