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Christopher Steven Manfred

Anesthesiology

Allopathic & Osteopathic Physicians

111 Colchester Ave, Burlington, VT 05401

PECOS Enrollment

This provider is enrolled in PECOS as CHRISTOPHER MANFRED.

Based on the most recent information from CMS, provider Christopher Steven Manfred is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1386810554
Provider Type
Individual
Full Name
Manfred, Christopher Steven
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/7/2008
Last Updated
1/24/2019

Contact Information

Practice Location

111 Colchester Ave, Burlington, VT 05401

(802) 847-2415

Unlisted Fax

Mailing Location

1349 Hill Street Ext, Berlin, VT 05602-8990

(802) 779-4917

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License 042.0014239 Vermont
Code 207L00000X	Description Anesthesiology Allopathic & Osteopathic Physicians	License 15036 New Hampshire
Code 207LC0200X	Description Anesthesiology Allopathic & Osteopathic Physicians	License 15036 New Hampshire
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 1020606	Description Medicaid	Issuer Unlisted Vermont
ID 32001409	Description Medicaid	Issuer Unlisted New Hampshire

Christopher Steven Manfred

PECOS Enrollment

Profile Details

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