Healthcare Provider Details

I. General information

NPI: 1215905435
Provider Name (Legal Business Name): DEBORAH S. HUBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 CATAMOUNT PARK EXCHANGE STREET
MIDDLEBURY VT
05753-1292
US

IV. Provider business mailing address

82 CATAMOUNT PARK EXCHANGE STREET
MIDDLEBURY VT
05753-1292
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-6777
  • Fax: 802-388-3445
Mailing address:
  • Phone: 802-388-6777
  • Fax: 802-388-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number039999
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042-0012447
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: