Provider Demographics
NPI:1295774818
Name:EVERETT, ELISE NEWHALL (MD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:NEWHALL
Last Name:EVERETT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:FLETCHER ALLEN HEALTHCARE, 111 COLCHESTER AVENUE
Mailing Address - Street 2:MAILSTOP 251 SM4
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-5110
Mailing Address - Fax:802-847-0496
Practice Address - Street 1:FLETCHER ALLEN HEALTHCARE, 111 COLCHESTER AVENUE
Practice Address - Street 2:AMBULATORY CARE CENTER, MAIN PAVILION, LEVEL 4
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-5110
Practice Address - Fax:802-847-0496
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-09-04
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Provider Licenses
StateLicense IDTaxonomies
VT042.0012288207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology