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1740975689
MICHAEL DEREVENSKY
BURLINGTON, VT
NPI
1740975689
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-06
Last Update Date
2023-04-06
Business Address
MICHAEL DEREVENSKY MD
111 COLCHESTER AVE
BURLINGTON, VT 05401-1473
Phone number: 802-847-2345
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Mailing Address
MICHAEL DEREVENSKY MD
111 COLCHESTER AVE
BURLINGTON, VT 05401-1473
Phone number:
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