Provider Demographics
NPI:1811976855
Name:LYNCH, DONALD F (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATT: CVMC FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-371-4820
Mailing Address - Fax:802-371-4855
Practice Address - Street 1:130 FISHER RD
Practice Address - Street 2:MOB-C SUITE 1
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-371-4820
Practice Address - Fax:802-371-4855
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2013-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101021068208800000X
VT042.0012709208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007501552Medicaid
VA331819OtherANTHEM BC BS
VT1021932Medicaid
VT003392701OtherMEDICARE PTAN LINKED TO CVMC MGP
VA15971OtherSENTARA HEALTHCARE
VA15971OtherSENTARA HEALTHCARE
VA007501552Medicaid
VA331819OtherANTHEM BC BS