Provider Demographics
NPI:1093715534
Name:ZAUR, ALAN LEONARD (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:LEONARD
Last Name:ZAUR
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 1:162 ELM ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2896
Mailing Address - Country:US
Mailing Address - Phone:802-229-2017
Mailing Address - Fax:802-223-0150
Practice Address - Street 1:162 ELM ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2896
Practice Address - Country:US
Practice Address - Phone:802-229-2017
Practice Address - Fax:802-223-0150
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT 042-00080022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009524Medicaid
VT33934OtherCIGNA/CIGNA BEHAVIORAL HEALTH
6500OtherBC/BS
20P200OtherMVP
20P200OtherMVP
B29775Medicare UPIN