Provider Demographics
NPI:1518321140
Name:KEM, MICHAEL DUNCAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DUNCAN
Last Name:KEM
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 1:20 W CANAL ST APT 131
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2133
Mailing Address - Country:US
Mailing Address - Phone:303-881-3215
Mailing Address - Fax:
Practice Address - Street 1:UVM MEDICAL CENTER DEPT OF ANESTHESIOLOGY
Practice Address - Street 2:111 COLCHESTER AVE, 222WP2
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-0001
Practice Address - Country:US
Practice Address - Phone:802-847-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT042.0014936207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty