Provider Demographics
NPI:1073596847
Name:GRAMLING, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:GRAMLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:UVM MEDICAL CENTER - PALLIATIVE CARE SERVICES
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-4848
Mailing Address - Fax:802-847-2929
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:UVM MEDICAL CENTER - PALLIATIVE CARE SERVICES
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-4848
Practice Address - Fax:802-847-2929
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10890207Q00000X
NY248222207QH0002X, 207Q00000X
VT042.0013387207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0279404OtherGHI
RI9022639Medicaid
NY000933333001OtherHEALTHNOW
NY0279404OtherGHI
RI0089022639Medicare PIN
RI9022639Medicaid