Provider Demographics
NPI:1497740047
Name:DURGIN, SCOTT W (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:DURGIN
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 1:539 ROUTE 121 E
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VT
Mailing Address - Zip Code:05146-9627
Mailing Address - Country:US
Mailing Address - Phone:802-843-1222
Mailing Address - Fax:
Practice Address - Street 1:539 ROUTE 121 E
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:VT
Practice Address - Zip Code:05146-9627
Practice Address - Country:US
Practice Address - Phone:802-843-1222
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010816207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010988Medicaid
VTVN3589Medicare ID - Type Unspecified
H90146Medicare UPIN