| Green Mountain Primary Care Plc | |
|
102a Court St Ste A Middlebury VT 05753-1455 | |
| (802) 382-0849 | |
| (802) 382-0144 |
| Full Name | Green Mountain Primary Care Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 102a Court St Ste A, Middlebury, Vermont |
| Authorized Official Name and Position | Laura Weylman (PHYSICIAN) |
| Authorized Official Contact | 8023820849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Mountain Primary Care Plc 1108 Quarry Rd Middlebury VT 05753-8951 Ph: (802) 349-3015 | Green Mountain Primary Care Plc 102a Court St Ste A Middlebury VT 05753-1455 Ph: (802) 382-0849 |
| NPI Number | 1265901938 |
|---|---|
| Provider Enumeration Date | 11/25/2018 |
| Last Update Date | 09/19/2021 |
| Medicare PECOS PAC ID | 5496090920 |
|---|---|
| Medicare Enrollment ID | O20190102002198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265901938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Laura E Weylman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932294295 PECOS PAC ID: 6901861830 Enrollment ID: I20081209000626 |
| Provider Name | Ania W Mortier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487052593 PECOS PAC ID: 4082932892 Enrollment ID: I20150407001569 |
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