Provider Demographics
NPI:1205220712
Name:FUERSTMAN, HOBIE
Entity Type:Individual
Prefix:
First Name:HOBIE
Middle Name:
Last Name:FUERSTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 ROOSEVELT HWY STE 210
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-4475
Mailing Address - Country:US
Mailing Address - Phone:802-879-6544
Mailing Address - Fax:802-879-0022
Practice Address - Street 1:905 ROOSEVELT HWY STE 210
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-4475
Practice Address - Country:US
Practice Address - Phone:802-879-6544
Practice Address - Fax:802-879-0022
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA16541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program