Provider Demographics
NPI:1932187267
Name:DESCHAMPS, CLAUDE (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:DESCHAMPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:EXECUTIVE OFFICE, PATRICK 318
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-2779
Mailing Address - Fax:802-847-5677
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:EXECUTIVE OFFICE, PATRICK 318
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-2779
Practice Address - Fax:802-847-5677
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29921208G00000X
VT0420012806208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN392227800Medicaid
MN330000102Medicare ID - Type Unspecified
D98318Medicare UPIN
MN392227800Medicaid