Provider Demographics
NPI:1184659104
Name:ENDRES, NATHAN K (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:K
Last Name:ENDRES
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 1:192 TILLEY DR
Mailing Address - Street 2:UVM MEDICAL CENTER
Mailing Address - City:S BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-847-2662
Mailing Address - Fax:
Practice Address - Street 1:192 TILLEY DRIVE
Practice Address - Street 2:UVM MEDICAL CENTER-ORTHOPEDIC SPECIALTY CENTER
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-847-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227762207X00000X
ME017559207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery