NPI 1023389418

Grigorios Delaportas, PA

Practitioner Physician Assistant South Burlington, VT

Practice location

Address: 192 Tilley Dr, South Burlington, VT 05403-4440
Phone: (802) 847-7063
Mailing address: 425 Hillwood Dr, Birmingham, AL 35209-5345

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1023389418
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jan 2012
Record last updated: 18 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.