Provider Demographics
NPI:1619172590
Name:GARAPATI, SREE SUSMITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SREE SUSMITHA
Middle Name:
Last Name:GARAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SREE
Other - Middle Name:SUSMITHA
Other - Last Name:GARAPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:111 COLCHESTER AVE.
Mailing Address - Street 2:UVM MEDICAL CENTER - MEDICINE/ENDOCRINOLOGY
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-4576
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE.
Practice Address - Street 2:UVM MEDICAL CENTER - MEDICINE/ENDOCRINOLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-4576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125050070207R00000X
VT042.0013200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036120507Medicaid
IL256510021Medicare PIN