Provider Demographics
NPI:1730682766
Name:MANCHESTER MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:MANCHESTER MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:802-768-1718
Mailing Address - Street 1:53 OLD COUNTY RD E
Mailing Address - Street 2:
Mailing Address - City:LANDGROVE
Mailing Address - State:VT
Mailing Address - Zip Code:05148-9632
Mailing Address - Country:US
Mailing Address - Phone:408-515-6815
Mailing Address - Fax:
Practice Address - Street 1:34 BONNET ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-8920
Practice Address - Country:US
Practice Address - Phone:408-515-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty