Provider Demographics
NPI:1396089751
Name:HIGGINS, MICHAEL P (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:P
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:UVM MEDICAL CENTER - SURGERY/CT & TRAUMA
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-4044
Mailing Address - Fax:802-847-8158
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:UVM MEDICAL CENTER - SURGERY/CT & TRAUMA
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-4044
Practice Address - Fax:802-847-8158
Is Sole Proprietor?:No
Enumeration Date:2012-11-23
Last Update Date:2015-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT055.0031259363AS0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program