Provider Demographics
NPI:1437262904
Name:STEINTHORSSON, GEORG (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORG
Middle Name:
Last Name:STEINTHORSSON
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 1:52 YACHT HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-7773
Mailing Address - Country:US
Mailing Address - Phone:802-985-5069
Mailing Address - Fax:802-847-3581
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:MAIN PAVILION-LEVEL 5 VASCULAR
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-4548
Practice Address - Fax:802-847-3581
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00105102086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02361484Medicaid
VT1009333Medicaid
NY02361484Medicaid
VN3056Medicare ID - Type Unspecified