Provider Demographics
NPI:1427012749
Name:TEPFER, BURTON DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:DAVID
Last Name:TEPFER
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 1:19 BELMONT AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-7109
Mailing Address - Country:US
Mailing Address - Phone:802-257-0505
Mailing Address - Fax:802-257-4665
Practice Address - Street 1:19 BELMONT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7109
Practice Address - Country:US
Practice Address - Phone:802-257-0505
Practice Address - Fax:802-257-4665
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0005683Medicaid
A40943Medicare UPIN
TEVT5683Medicare ID - Type Unspecified