Provider Demographics
NPI:1932122264
Name:YOUNG, MICHELLE LYNN (MD, FRCSC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SWIFT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7359
Mailing Address - Country:US
Mailing Address - Phone:802-864-3937
Mailing Address - Fax:802-864-3936
Practice Address - Street 1:99 SWIFT ST STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7359
Practice Address - Country:US
Practice Address - Phone:802-864-3937
Practice Address - Fax:802-864-3936
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0010188207WX0107X
VT0420010188207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTH37511Medicaid
VTYOVN3552Medicare ID - Type Unspecified
VTH37511Medicaid