Provider Demographics
NPI:1023695194
Name:ADAMS, LAUREN STEFANIE (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:STEFANIE
Last Name:ADAMS
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 1:426 INDUSTRIAL AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-4449
Mailing Address - Country:US
Mailing Address - Phone:802-878-1008
Mailing Address - Fax:
Practice Address - Street 1:426 INDUSTRIAL AVE STE 130
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4449
Practice Address - Country:US
Practice Address - Phone:802-878-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0018035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine