Dr. Miriam Blodgett Tatum
M.D. | Pediatric Adolescent Medicine | Female
Dr. Miriam Blodgett Tatum, M.D. is a Derby Line, Vermont based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Dr. Miriam Blodgett Tatum is
159 Main Street, Derby Line, Vermont - 05830. She can be contacted on phone at
802-873-3009.
Dr. Miriam Blodgett Tatum is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Miriam Blodgett Tatum is
1770682106 which was assigned by NPPES on 22 Sep, 2006 and it was last updated on 08 Jul, 2007.
Dr. Miriam Blodgett Tatum license number is
042-0008370 for Pediatrics Adolescent Medicine (2080A0000X) in Vermont.
Dr. Miriam Blodgett Tatum specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Dr. Miriam Blodgett Tatum basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Dr. Miriam Blodgett Tatum |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Dr. Miriam Blodgett Tatum address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 159 Main Street
Derby Line, VT, 05830
United States |
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| Phone Number : | 802-873-3009 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1770682106 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 22 Sep, 2006 |
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| Last Updated On : | 08 Jul, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Miriam Blodgett Tatum are as mentioned. Primary taxonomy code for Dr. Miriam Blodgett Tatum, M.D. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 042-0008370 | VT |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Miriam Blodgett Tatum such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 042-0008370 | Other | VT | STATE LICENSE NUMBER |
| 0VN0264 | MEDICAID | VT | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 970, 159 Main Street
Derby Line, VT, 05830-0970
United States |
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| Phone Number : | 802-873-3009 |
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Business Location:
Patients can refer following map for directions to
Dr. Miriam Blodgett Tatum practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.