Healthcare Provider Details

I. General information

NPI: 1871534529
Provider Name (Legal Business Name): DONALD N WEINBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FISHER RD HOSPITALIST
BERLIN VT
05602-9516
US

IV. Provider business mailing address

PO BOX 547 ATT: CVMC FINANCE DEPT
BARRE VT
05641-0547
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-1743
  • Fax: 802-225-1745
Mailing address:
  • Phone: 802-225-1743
  • Fax: 802-225-1745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number042.0008153
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number042.0008153
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: