Provider Demographics
NPI:1437281045
Name:MAPLEWOOD FAMILY PRACTICE, P.C.
Entity Type:Organization
Organization Name:MAPLEWOOD FAMILY PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAASCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-254-1311
Mailing Address - Street 1:120 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6818
Mailing Address - Country:US
Mailing Address - Phone:802-254-1311
Mailing Address - Fax:802-254-9211
Practice Address - Street 1:120 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6818
Practice Address - Country:US
Practice Address - Phone:802-254-1311
Practice Address - Fax:802-254-9211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN2320Medicaid
VT0VN2320Medicaid