Provider Demographics
NPI:1528043569
Name:ASNIS, ERIC L (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:L
Last Name:ASNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 HOSPITAL LOOP
Mailing Address - Street 2:SUITE #7
Mailing Address - City:BERLIN
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9522
Mailing Address - Country:US
Mailing Address - Phone:802-229-9144
Mailing Address - Fax:802-223-1697
Practice Address - Street 1:195 HOSPITAL LOOP
Practice Address - Street 2:SUITE #7
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9522
Practice Address - Country:US
Practice Address - Phone:802-229-9144
Practice Address - Fax:802-223-1697
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT9030207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1026Medicaid
VT020015048OtherRAILROAD MEDICARE
VTVN1026Medicare UPIN
VTE88266Medicare UPIN