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RICHARD N CLATTENBURG MD
>> Emergency Medical Technician, Basic >> Emergency Medical Service ProvidersRegistrant NPI Number: 1457346124
Individual Registrant: RICHARD N CLATTENBURG MD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1067 CADY HILL RD PERKINSVILLE, VT 05151-9523 US
Tel: 802-263-5505 Fax: 802-263-5594
Tel: 802-263-5505 Fax: 802-263-5594
Contact information for business:
1067 CADY HILL RD PERKINSVILLE, VT 05151-9523 US
Tel: 802-263-5505 Fax: 802-263-5594
Tel: 802-263-5505 Fax: 802-263-5594
Registration Information:
NPI: 1457346124
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Service Providers Emergency Medical Technician, Basic | VT | 0420006288 |
| N | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | VT | 042-0006288 |
| Y | 2080P0006X | Allopathic & Osteopathic Physicians Pediatrics | VT | 042-0006288 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 0005110 | VT | 05 |
