Provider Demographics
NPI:1053318766
Name:UNGER, PAUL STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:STEPHEN
Last Name:UNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:792 COLLEGE PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3052
Mailing Address - Country:US
Mailing Address - Phone:802-655-3400
Mailing Address - Fax:802-655-9170
Practice Address - Street 1:792 COLLEGE PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-655-3400
Practice Address - Fax:802-655-9170
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0008105207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009983Medicaid
VT0009983Medicaid
VTVT5418Medicare ID - Type Unspecified