Provider Demographics
NPI:1275845943
Name:DOUGLAS L. DIER, M.D., P.C
Entity Type:Organization
Organization Name:DOUGLAS L. DIER, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-775-3374
Mailing Address - Street 1:98 ALLEN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4776
Mailing Address - Country:US
Mailing Address - Phone:802-775-3374
Mailing Address - Fax:802-747-4521
Practice Address - Street 1:98 ALLEN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4776
Practice Address - Country:US
Practice Address - Phone:802-775-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0007797207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1018191Medicaid