| Green Mountain Infectious Disease Llc | |
|
69 Allen St Ste 8 Rutland VT 05701-4564 | |
| (207) 807-4452 | |
| Not Available |
| Full Name | Green Mountain Infectious Disease Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 69 Allen St Ste 8, Rutland, Vermont |
| Authorized Official Name and Position | John Gavin Cotter (PROVIDER/OWNER) |
| Authorized Official Contact | 2078074452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Mountain Infectious Disease Llc 69 Allen St Ste 8 Rutland VT 05701-4564 Ph: (207) 807-4452 | Green Mountain Infectious Disease Llc 69 Allen St Ste 8 Rutland VT 05701-4564 Ph: (207) 807-4452 |
| NPI Number | 1205640604 |
|---|---|
| Provider Enumeration Date | 02/05/2025 |
| Last Update Date | 07/10/2025 |
| Medicare PECOS PAC ID | 4183133762 |
|---|---|
| Medicare Enrollment ID | O20250604002370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205640604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | John Cotter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245331321 PECOS PAC ID: 1052303369 Enrollment ID: I20160707000747 |
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