Provider Demographics
NPI:1558533430
Name:STEBBINS, EMILY L A (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:L A
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LOUISE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:111 COLCHESTER AVE # WP-2
Mailing Address - Street 2:FLETCHER ALLEN HEALTH CARE, DEPT OF ANESTHESIOLOGY
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-2717
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE # WP-2
Practice Address - Street 2:FLETCHER ALLEN HEALTH CARE, DEPT OF ANESTHESIOLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2013-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201278207LP3000X
390200000X
VT0420012590207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program