Provider Demographics
NPI:1871598722
Name:BISBEE, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:BISBEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 357
Mailing Address - Street 2:53 OLD FARM ROAD
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-0357
Mailing Address - Country:US
Mailing Address - Phone:802-253-5020
Mailing Address - Fax:802-253-5021
Practice Address - Street 1:53 OLD FARM ROAD
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-0357
Practice Address - Country:US
Practice Address - Phone:802-253-5020
Practice Address - Fax:802-253-5021
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT0420007377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00005858OtherBLUE CROSS
VT566280OtherCIGNA
VT043358048OtherCOMMERCIAL INSURANCE
VT080185842OtherRAILROAD MEDICARE
VT78204OtherMVP
VTPENDINGMedicaid
VT78204OtherMVP
VTY400107339Medicare PIN