Provider Demographics
NPI:1528190113
Name:SOWDEN, MICHELLE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:SOWDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BEAUMONT AVE
Mailing Address - Street 2:GIVEN BUILDING - B227
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05405-1742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 BEAUMONT AVE
Practice Address - Street 2:GIVEN BUILDING - B227
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-1742
Practice Address - Country:US
Practice Address - Phone:802-656-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT032 0000546208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery