IndividualActive
Miriam Tatum, M.D.
NPI 1770682106 · Pediatric Adolescent Medicine Physician · Derby Line, VT
Provider details
- NPI number
- 1770682106
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 042-0008370 (VT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
159 Main Street
Derby Line, VT 05830
Phone: (802) 873-3009
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 970
Derby Line, VT 05830-0970
Registry dates
- Enumerated
- 2006-09-22
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.