Healthcare Provider Details

I. General information

NPI: 1417065178
Provider Name (Legal Business Name): ASSOCIATES IN GASTROENTEROLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 COLCHESTER AVE
BURLINGTON VT
05401-1424
US

IV. Provider business mailing address

60 COLCHESTER AVE
BURLINGTON VT
05401-1424
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-7483
  • Fax: 802-660-4337
Mailing address:
  • Phone: 802-864-7483
  • Fax: 802-660-4337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL J MAYER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 802-864-7483