Provider Demographics
NPI:1164447520
Name:PLANTE, MARK KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:KENNETH
Last Name:PLANTE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:77 OVERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-1287
Mailing Address - Country:US
Mailing Address - Phone:802-847-2884
Mailing Address - Fax:802-847-6020
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:EAST PAVILION-LEVEL 5 UROLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-2884
Practice Address - Fax:802-847-6020
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VT042-0009377208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology