Provider Demographics
NPI:1407966682
Name:TREMBLEY, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:TREMBLEY
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 1:41 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9835
Mailing Address - Country:US
Mailing Address - Phone:802-334-3504
Mailing Address - Fax:802-334-3512
Practice Address - Street 1:41 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9835
Practice Address - Country:US
Practice Address - Phone:802-334-3504
Practice Address - Fax:802-334-3512
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420007285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002510Medicaid
VT0002510OtherBLUE SHIELD
VT11586OtherMVP
VT0002510Medicaid
VT11586OtherMVP