Provider Demographics
NPI:1629005582
Name:VERMUND, STEN H (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:STEN
Middle Name:H
Last Name:VERMUND
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 COLLEGE ST RM 431
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3201
Mailing Address - Country:US
Mailing Address - Phone:615-720-3677
Mailing Address - Fax:203-785-6103
Practice Address - Street 1:60 COLLEGE ST RM 431
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3201
Practice Address - Country:US
Practice Address - Phone:615-720-3677
Practice Address - Fax:203-785-6103
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137172208000000X, 2083P0901X
TNMD406852083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B19327Medicare UPIN