Provider Demographics
NPI:1568492510
Name:LEMEI, SUSAN LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:LEMEI
Suffix:
Gender:F
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:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05143-1024
Mailing Address - Country:US
Mailing Address - Phone:802-875-5660
Mailing Address - Fax:802-875-5661
Practice Address - Street 1:23 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VT
Practice Address - Zip Code:05143
Practice Address - Country:US
Practice Address - Phone:802-875-5660
Practice Address - Fax:802-875-5661
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010822Medicaid
VTG80988Medicare UPIN
VTVN3483Medicare PIN