Provider Demographics
NPI:1255358099
Name:TALMADGE, BRUCE A (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:A
Last Name:TALMADGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:CVMC MEDICAL GROUP PRACTICES
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-371-5326
Mailing Address - Fax:802-371-5339
Practice Address - Street 1:225 S MAIN ST
Practice Address - Street 2:BARRE INTERNAL MEDICINE
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4815
Practice Address - Country:US
Practice Address - Phone:802-479-3302
Practice Address - Fax:802-371-2517
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0006067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN2501Medicaid
VTOVN2501Medicaid
VN2501Medicare ID - Type Unspecified