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Contact Information

MARK C BISANZO, MD
111 COLCHESTER AVE.
UVM MEDICAL CENTER - DEPT. OF SURGERY/ED
BURLINGTON, VT05401
 Phone: 802-847-2434
 Fax: 802-847-4802
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MARK C BISANZO · (Male)

NPI Number 1740249226
Status Active
Credentials MD
Entity Individual
Enumeration date 03/22/2006
Last updated 05/22/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 44481
  • MA License # 222871
  • VT License # 042-0013299
  • MA Medicaid 110075594A
Hospital affiliation(s)
  • CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR - (Acute Care)
    75 BEEKMAN STREET
    PLATTSBURGH, NY 12901
  • ELIZABETHTOWN COMMUNITY HOSPITAL - (Critical Access)
    75 PARK STREET
    ELIZABETHTOWN, NY 12932
  • FLETCHER ALLEN HOSPITAL OF VERMONT - (Acute Care)
    111 COLCHESTER AVE
    BURLINGTON, VT 05401
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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