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Contact Information

THOMAS SUPPAN, MD
111 COLCHESTER AVE
BURLINGTON, VT05401-1473
 Phone: 802-847-2377
 Fax: 802-847-9644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for THOMAS SUPPAN · (Male)

NPI Number 1386679678
Status Active
Credentials MD
Entity Individual
Enumeration date 07/12/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • VT License # 042-0009724
  • NY Medicaid 01866444
  • VT Medicaid 0VN1782
Hospital affiliation(s)
  • NORTHWESTERN MEDICAL CENTER INC - (Acute Care)
    133 FAIRFIELD STREET
    SAINT ALBANS, VT 05478
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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